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目的观察吡格列酮降血糖、降血脂、降血压及改善胰岛素敏感性作用。方法选择医院住院及门诊2型糖尿病患者62例,随机分为治疗组和对照组各31例。对照组给予二甲双胍500mg,口服,2次/d;治疗组给予吡格列酮30mg,口服,1次/d。2组疗程均为12周,观察2组治疗前后空腹及餐后血糖、血脂、血压、胰岛素等指标的变化。结果 2组治疗后血糖、糖化血红蛋白(Hb A1c)均较治疗前明显下降(P<0.01),组间比较差异无统计学意义(P>0.05)。治疗组胰岛素、C肽水平均明显下降(P<0.01),对照组餐后2h胰岛素下降(P<0.05)。治疗组三酰甘油明显下降,高密度脂蛋白胆固醇(HDL-C)较治疗前升高(均P<0.01)。对照组血脂各项指标较治疗前亦有明显变化(P均<0.01)。2组间比较,总胆固醇(TG)和低密度脂蛋白胆固醇变化有差异(P<0.01或P<0.05),但2组不良反应发生率比较差异无统计学意义(P>0.05)。结论吡格列酮具有降血糖、降TG、降血压、升高HDL-C的作用。吡格列酮还可显著降低2型糖尿病患者胰岛素和C肽水平,增加胰岛素敏感性,改善胰岛素抵抗。
Objective To observe the effect of pioglitazone on lowering blood sugar, lowering blood pressure, lowering blood pressure and improving insulin sensitivity. Methods Sixty-two inpatients and outpatients with type 2 diabetes mellitus were randomly divided into treatment group (n = 31) and control group (n = 31). Control group was given metformin 500mg, orally, 2 times / d; the treatment group was given pioglitazone 30mg, orally, 1 time / d. The two groups were treated for 12 weeks, and the fasting and postprandial blood glucose, blood lipid, blood pressure, insulin and other indexes before and after treatment were observed. Results After treatment, the blood glucose and Hb A1c in both groups were significantly lower than those before treatment (P <0.01). There was no significant difference between the two groups (P> 0.05). The levels of insulin and C-peptide in the treatment group were significantly decreased (P <0.01), and the insulin level in the control group decreased 2 h after meal (P <0.05). Treatment group, triglyceride decreased significantly, high-density lipoprotein cholesterol (HDL-C) increased compared with before treatment (all P <0.01). The indexes of blood lipids in the control group also had significant changes compared with those before treatment (all P <0.01). There were significant differences between the two groups in the changes of total cholesterol (TG) and low density lipoprotein cholesterol (P <0.01 or P <0.05), but there was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Pioglitazone has the effects of lowering blood sugar, lowering TG, lowering blood pressure and increasing HDL-C. Pioglitazone can also significantly reduce insulin and C-peptide levels in patients with type 2 diabetes, increase insulin sensitivity and improve insulin resistance.