第九章 格列本脲联合二甲双胍长期治疗对2型糖尿病患者.docVIP

格列本脲联合二甲双胍长期治疗对2型糖尿病患者 胰岛素抵抗的影响 本文档由【中文word文档库】提供，转载分发敬请保留本信息； 中文word文档库免费提供海量范文、教育、学习、政策、报告和经济类word文档。 杨 媚1，滕小春1，杨刚毅2，未友能1，郭 玲1，何渝忠1，刘 红1，庞小芬1 （1.重庆钢铁总医院老年科，重庆 400081；2. 重庆医科大学附属第二医院内分泌科，重庆400010） 【摘要】 目的 探讨格列本脲联合二甲双胍对2型糖尿病(T2DM)患者糖代谢和胰岛素功能的影响。方法 选取我院门诊病人61例，分为格列本脲治疗（格列本脲组，n=32）保持平时服用二甲双胍的剂量不变。随访24周，每4周根据空腹血糖调整剂量HOMA-IR)。治疗后HbA1c较治疗前显著降低P0.01）。格列本脲+二甲双胍组治疗后Fns和HOMA-IR较治疗前均有显著降低P 0.05）结论 格列本脲单用或与二甲双胍合用都能有效降低血糖，β细但格列本脲二甲双胍The effect of daonil combined with metformin on insulin resistance of type 2 diabetic patients.YANG Mei，TENG Xiao-chun, YANG Gang-yi，geronotology，The Hospital of steel，Chongqing 400081,CHINA 【Abstract】 Objective To investigate the effect of daonil combined with metformin on glycometabolism and insulin function of type 2 diabetic patients. Methods This 24一week study includedtype 2 diabetic patients from out-patient clinic of our hospital. Among these patients, 32 subjects who didn’t accept any drug treatment received daonil. Another 29 subjects received daonil plus metformin which retained the same doses in normal time. The doses of daonil were adjusted through fasting blood glucose levels every 4 weeks. The levels of blood fat, plasma glucose, plasma insulin, C peptide were assayed before and after treatment, and ------------------------- 作者简介：杨 媚（1978-），女，重庆人，主治医师，硕士。 HOMA-IR was also calculated. Results At the end of treatment, the levels of HbA1c in two groups were significantly reduced（均P0.01）, and the levels of fasting plasma insulin and HOMA-IR were obviously decreased too.（均P0.05）Conclusion Daonil alone or daonil plus metformin can decrease plasma glucose levels, rather than obviously damage the function of pancreatic beta cells. While daonil plus metformin is somewhat better than daonil in improving insulin resistance． Keywords】Daonil；Metformin；Type 2 Diabetes；Insulin resistance 2型糖尿病(T2DM)的病理生理改变主要是胰岛素抵抗(IR)和胰岛素分泌不足。对于伴有明显IR的T2DM患者，口服降糖药治疗在糖尿病治疗中占有重要地位，而以格列本脲为代表的磺脲类和二甲双胍均为临床一线用药，都有改善糖代谢作用，但两者作用机制不同。格列本脲促进胰岛素分泌，而二甲双胍可改善胰岛素抵抗，因此，二者联合