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格列美脲對2型糖尿病患者心血管保護作用臨床觀察

摘要:目的: 觀察格列美脲對2型糖尿病患者心血管的保護作用并探討其可能的機制。 方法 :112例T2DM患者隨機分為格列美脲組(格列美脲+二甲雙胍)和對照組(格列本脲+二甲雙胍),觀察治療前后兩者空腹及餐后兩小時血糖(FBG,2hPBG)、糖化血紅蛋白(HbA1c)、空腹胰島素(FINS)、HOMA模型胰島素抵抗指數(HOMAIR)、甘油三脂(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDLC)、低密度脂蛋白膽固醇(LDLC)、同型半胱氨酸(HCY)、血漿脂聯素的變化。 結果 :兩組患者的TC、LDLC、TG、FBG、2hPBG都較治療前降低,連續服用6個月以上格列美脲的T2DM患者其血漿HCY、HOMAIR、血糖水平明顯下降,血漿脂聯素水平明顯升高,與對照組相比差異有統計學意義(〖WTBX〗P lt;005)。 結論 :格列美脲能降低多項心血管危險因子水平,對血脂、HCY和動脈粥樣硬化都有良性調節作用,其作用基礎可能與改善胰島素抵抗,增加血漿脂聯素相關。Abstract: Objective: To observe the protective effects and to explore mechanisms of glimepiride on cardiovascular system of Type 2 Diabetes Mellitus. Methods : 112 patients with type 2 diabetes mellitus were randomly divided into treatment group (glimepiride combined with metformin) and control group (glibenclamide combined with metformin). The fasting blood glucose (FBG), 2hPBG, hemoglobin A1c (HbA1c), FINS, HOMAIR, blood lipid (TC, TG, LDLC and HDLC), HCY (homocysteine) and adiponectin were detected before and after treatment. Results : In all cases, the level of TC、LDLC、TG、FBG、2hPBG were decreased after treated with glimepiride or glibenclamide combined with metformin for 6 monthes. Moreover, the level of HCY, HOMAIR and blood glucose were decreased and the level of adiponectin was increased significantly than that of in control group (Plt;005). Conclusion : Glimepiride showed the effective on decreasing the risk factor of cardiovascular system disease with regulation of blood lipid, HCY, and improve the atherosclerosis. The effective of glimepiride on cardiovascular system was relation to improved the insulin resistance and increase the adiponectin.