生活方式联合米格列醇干预治疗糖耐量异常患者疗效评估

Effect of life-style combined with miglitol on treating the patients with impaired glucose tolerance

目的观察和分析生活方式联合米格列醇干预治疗糖耐量异常患者糖代谢水平、炎症因子、转化率及心血管事件发生率的影响。方法纳入糖耐量异常患者258例,根据随机数字法随机将患者分为生活方式干预组(A组)、米格列醇治疗组(B组)、生活方式联合米格列醇治疗组(C组),每组各86例。测量并比较三组患者干预前后糖代谢空腹血糖(FPG)、餐后2 h血糖(2 h PG)、甘油三酯(TG)等生化指标,血清炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs CRP)水平,颈动脉内膜中层厚度(IMT)、颈动脉-股动脉脉搏波速度(CF-PWV)、肱动脉中血流介导的血管扩张(FMD)程度。结果 C组FPG、2 h PG、TG、IL-6、TNF-α、hs CRP、IMT、CF-PWV水平明显低于A组、B组,差异具有统计学意义(t分别=2.56、4.64、4.03、3.04、4.20、1.66、8.57、3.38、5.47、2.73、5.09、1.99、4.82、3.25、5.47、2.12,P均<0.05),但FMD水平明显高于A组、B组(t分别=-4.44、-2.26,P<0.05)。C组糖耐量异常患者糖尿病转化率明显低于A组,差异有统计学意义(χ~2=6.34,P<0.05),但与B组比较,但差异无统计学意义(χ~2=0.45,P>0.05)。C组糖耐量异常患者心血管事件发生率明显低于A组,差异有统计学意义(χ~2=7.16,P<0.05),但与B组比较,差异无统计学意义(χ~2=2.08,P>0.05)。结论生活方式联合米格列醇的干预治疗方式可改善糖耐量异常患者糖代谢水平,降低糖耐量异常患者的糖尿病转化率,改善糖耐量异常患者炎症因子水平及血管功能,可有效延缓糖耐量异常患者向糖尿病的转变,预防糖尿病的发生。

Objective To observe and analyze the influence of lifestyle combined with miglitol on glucose metabolism,inflammatory factors,conversion rate and incidence of cardiovascular events in patients with impaired glucose tolerance.Methods Totally 258 patients with impaired glucose tolerance were randomized into lifestyle intervention group（group A）,miglitol treatment group（group B）and lifestyle combined with miglitol group（group C）according to the random numbermethod,with 86 patients in each group. The levels of fasting plasma glucose（FPG）,2 h postprandial glucose（2 hPG）,triglyceride（TG）,interleukin-6（IL-6）,tumor necrosis TNF-α,hsCRP,carotid intima-media thickness（IMT）,carotidfemoralartery pulse wave velocity（CF-PWV）and flow-mediated diastolic function（FMD）were detected and compared.Results After intervention,the levels of FPG,2 hPG,TG,IL-6,TNF-α,hsCRP,IMT and CF-PWV in group C weresignificantly lower than those in group A and group B（t = 2.56,4.64,4.03,3.04,4.20,1.66,8.57,3.38,5.47,2.73,5.09,1.99,4.82,3.25,5.47,2.12,P〈0.05）,but the level of FMD was significantly higher than group A and group B（t = -4.44,-2.26,P〈0.05）. Diabetes mellitus conversion rate of group C was significantly lower than the group A（χ2 = 6.34,P〈0.05）,but there was not significantly different between the group C and group B （χ2 = 0.45,P〉0.05）. The incidence ofcardiovascular events of group C was significantly lower than that of the group A（χ2= 7.16,P〈0.05）,but when comparingwith the group B,the difference was not statisticallysignificant（χ2=2.08,P〉0.05）.Conclusion Interventionsof life -style combined with miglitol can improve glucosemetabolism in patients with impaired glucose tolerance,reduce diabetes conversion in patients with impaired·278·glucose tolerance,and improve the level of inflammatory cytokines and vascular function in patients with impaired glucosetolerance,which can effectively prevent the occurrence of diabetes.