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目的观察马来酸罗格列酮治疗2型糖尿病(T2DM)前后血清高敏C反应蛋白(hsCRP)的变化,探讨其可能的药物作用。方法86例双胍类和磺脲类药物治疗3个月以上的T2DM病人随机分为罗格列酮组与对照组,进行为期16周的临床观察。结果罗格列酮组治疗前后比较空腹血糖(FPG)、餐后2h血糖(PPG)及糖化血红蛋白(HbA1 c)均明显下降(P<0.01),胰岛素抵抗指数(IR I)明显下降(P<0.05),高密度脂蛋白胆固醇(HDL-C)明显升高(P<0.01),低密度脂蛋白胆固醇(LDL-C)明显下降(P<0.01),胆固醇(CH)和甘油三酯(TG)无明显变化,收缩压(SBP)平均下降9.6mm Hg(P<0.01),舒张压(DBP)平均下降6.1mm Hg(P<0.01),体重指数(BM I)无明显变化,hsCRP明显下降(P<0.01)。而对照组各观察指标无明显变化。结论T2DM患者慢性高血糖状态与炎症关系密切。罗格列酮治疗在改善胰岛素敏感性的同时,还具有抗炎、调脂、降压等作用,长期使用可预防T2DM心血管疾病的发生。
Objective To observe the changes of serum high sensitive C-reactive protein (hsCRP) before and after treatment of type 2 diabetes mellitus (T2DM) with rosiglitazone maleate and to explore the possible drug effects. Methods A total of 86 patients with T2DM treated with biguanides and sulfonylureas for more than 3 months were randomly divided into rosiglitazone group and control group for 16 weeks. Results Before and after treatment, fasting blood glucose (FPG), postprandial blood glucose (PPG) and HbA1c were significantly decreased (P <0.01) and insulin resistance index (IRI) (P <0.01), low density lipoprotein cholesterol (LDL-C) decreased significantly (P <0.01), while cholesterol (CH) and triglyceride (P <0.01), diastolic blood pressure (DBP) decreased by 6.1 mm Hg (P <0.01), but the body mass index (BM I) had no significant change, hsCRP decreased significantly (P <0.01). The control group no significant changes in the observation indicators. Conclusion There is a close relationship between chronic hyperglycemia and inflammation in T2DM patients. Rosiglitazone treatment in improving insulin sensitivity, but also has anti-inflammatory, lipid-lowering, antihypertensive effect, long-term use can prevent the occurrence of T2DM cardiovascular disease.