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目的探讨二甲双胍格列吡嗪复方制剂与单药二甲双胍或格列吡嗪对T2DM患者氧化应激水平的影响。方法将90例T2DM患者为3组,A组35例,予二甲双胍格列吡嗪复方制剂;B组30例,予二甲双胍片;C组25例,予格列吡嗪片,疗程均为12周。治疗前后均检测FPG、2hPG、HbA1c、FIns及2hIns水平,计算HOMA-IR、HOMA-β。试验前后留取血清测定血清8-异前列腺素F2α(8-iso-PGF2α)。结果 3组治疗后血清8-iso-PGF2α水平均有下降,仅A组治疗前后差异有统计学意义(P<0.001);A、C组HbA1c水平治疗前后差异有统计学意义(P<0.001);A、C组FPG、2hPG水平降低(P<0.05);A组治疗前后HOMA-IR差异有统计学意义(P<0.01)。Pearson相关性分析显示8-iso-PGF2α水平与2hPG、2hIns、HbA1c、HOMA-IR呈相关关系(r=0.199,P<0.05;r=0.206,P<0.05;r=-0.276,P<0.01;r=-0.451,P<0.002)。结论二甲双胍格列吡嗪复方制剂既能良好地控制患者血糖,亦能显著地改善患者氧化应激水平,从而间接改善患者的血糖波动,有效控制并发症的发生。
Objective To investigate the effects of metformin glipizide and metformin or glipizide on oxidative stress in T2DM patients. Methods 90 patients with T2DM were divided into 3 groups, 35 patients in group A received metformin and glipizide, 30 patients in group B received metformin tablets, 25 patients in group C received glipizide for 12 weeks . The levels of FPG, 2hPG, HbA1c, FIns and 2hIns were measured before and after treatment, HOMA-IR and HOMA-β were calculated. Serum 8-iso-prostaglandin F2α (8-iso-PGF2α) was measured before and after the test. Results The levels of serum 8-iso-PGF2α in three groups decreased after treatment, but there was significant difference between before and after treatment in group A (P <0.001). The levels of HbA1c in group A and C were significantly different (P <0.001) . The levels of FPG and 2hPG in group A and C decreased (P <0.05). The difference of HOMA-IR before and after treatment in group A was statistically significant (P <0.01). Pearson correlation analysis showed that the level of 8-iso-PGF2α was correlated with 2hPG, 2hIns, HbA1c and HOMA-IR (r = 0.199, P <0.05; r = 0.206, r = -0.451, P <0.002). Conclusion Metformin glibenclamide can not only control the blood glucose of patients well, but also significantly improve the level of oxidative stress in patients, so as to indirectly improve the patients’ blood glucose and effectively control the complications.