罗格列酮联合胰岛素泵强化治疗2型糖尿病的疗效及对血管内皮依赖性舒张功能的影响

Curative Effect of Rosiglitazone Combined with Insulin Pump and Their Influence on Vascular Endothelial Function in Patients with Type 2 Diabetes Mellitus

目的探讨罗格列酮联合胰岛素泵(CSⅡ)强化治疗2型糖尿病的疗效及对患者血管内皮功能的影响。方法选择2型糖尿病患者84例,按随机数表法将患者分为观察组和对照组各42例。观察组采用罗格列酮联合CSⅡ治疗,对照组采用CSⅡ治疗。连续治疗2周后观察两组患者疗效、血管内皮依赖性舒张功能(EDD)变化、血糖达标时间、胰岛素用量以及不良反应发生情况。结果两组患者治疗后空腹血糖、餐后2 h血糖、总胆固醇(TC)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)均较治疗前显著降低,胰岛素敏感指数(ISI)较治疗前显著升高(P均<0.05);而两组患者体重指数、甘油三酯、高密度脂蛋白、低密度脂蛋白治疗前后无显著变化(P>0.05)。治疗后,观察组TC、HbA1c、HOMA-IR均显著低于对照组(P均<0.05)。两组患者治疗后EDD均较治疗前显著升高(P<0.05);治疗后,观察组EDD显著高于对照组(P<0.05)。观察组血糖达标时间以及胰岛素用量均显著低于对照组(P<0.05),两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论罗格列酮联合胰岛素泵强化治疗更能有效减轻2型糖尿病患者胰岛素抵抗,改善患者血管内皮功能,且不良反应少。

Objective To investigate the curative effect of rosiglitazone combined with insulin pump （ CSⅡ） and the influence on vascular endothelial function in patients with type 2 diabetes mellitus（T2DM）.Methods Eighty-four patients with T2DM were randomly divided into observation group and control group ,with 42 cases in each group .The patients in the control group were treated with CSⅡ,while the patients in the observation group were treated with rosiglitazone combined with CSⅡ.The treatment lasted for 2 weeks.The curative effect ,changes in vascular endothelium-dependent relaxing function（EDD）,time of blood glucose control in target,dosage of insulin,and adverse reactions occurring were observed in both groups.Results Fasting blood glucose（FBG）,postprandial 2 hours blood glucose（2hPG）,total cholesterol（TC）,glycosylated hemoglobin（HbA1c）,insulin resistance index（HOMA-IR） in two groups after treatment were significantly lower than those before treatment （ all P 〈0 .05 ） , while insulin sensitivity index （ ISI ） after treatment increased significantly （ P〈0 .05 ） .No significant difference was observed in body mass index （ BMI ） , triglyceride （ TG ） , high-density lipoprotein（HDL）,low-density lipoprotein（LDL） before and after treatment（P〉0.05）.After treatment,TC,HbA1c and HOMA-IR in the observation group were significantly lower than those in the control group （all P〈0.05）.EDD in two groups after treatment was significantly higher than that before treatment （P〈0.05）,and EDD in the observation group was significantly higher than that in the control group after treatment （ P〈0 .05 ） .The time of blood glucose control in target and insulin dosage in the observation group were significantly lower than those in the control group＆amp;nbsp;（P〈0.05）,there was no significant difference in the incidence of adverse reactions between two groups （P〉0.05）. Conclusion Rosiglitazone combined with insulin pump can relieve insulin resistance more effectively in patients with T2DM and improve the function of vascular endothelial .The adverse reactions are few .