初诊2型糖尿病患者罗格列酮治疗对颈动脉内膜中层厚度影响.docVIP

初诊2型糖尿病患者罗格列酮治疗对颈动脉内膜中层厚度影响[摘要] 目的：观察初诊2型糖尿病患者颈动脉内膜中层厚度（IMT）的变化，探讨罗格列酮的抗动脉粥样硬化作用及其机制。方法：初诊2型糖尿病患者91例随机分为罗格列酮治疗组和对照组。高分辨超声测量IMT，治疗12周后复测IMT，比较治疗前后的变化。结果：罗格列酮治疗组治疗后IMT值显著降低（P＜0.05)。对照组治疗前后无显著性差异（P＞0.05）。两组间治疗前后IMT值比较差异具有显著性（P＜0.05)。结论：罗格列酮能显著降低初诊2型糖尿病患者IMT水平，并可能抑制糖尿病患者早期动脉粥样硬化的发生和发展。 [关键词] 罗格列酮；2型糖尿病；颈动脉内膜中层厚度；噻唑烷二酮；动脉粥样硬化 [中图分类号] R587.1 [文献标识码]A [文章编号]1673-7210（2008）07（c）-029-02 Effects of rosiglitazone on carotid intima-media thickness in newly diagnosed type 2 diabetic patients JU Wei, ZHAO Xiao-juan (China Medical University, Shenyang 110001,China ) [Abstract] Objective:To investigate the change of carotid intima-media thickness(IMT) in newly diagnosed type 2 diabetic patients and anti-atherosclerosis effects of rosiglitazone. Methods: Ninety-one newly diagnosed type 2 diabetic patients were divided randomly into rosiglitazone treatment group and control group. They all received the treatment for 12 weeks. The IMT was measured by high resolution ultrasonography, and the changes of IMT were compared. Results:After treatment with rosiglitazone, IMT levels decreased significantly（P＜0.05).There was no obvious change in the control group before and after treatment（P＞0.05）.The changes of IMT in the two groups were significant（P＜0.05).Conclusion:IMT can be reduced significantly in the newly diagnosed type 2 diabetic patients after being treated with rosiglitazone,which maybe delay the occurrence and development of atherosclerosis. [Key words] Rosiglitazone；Type 2 diabetes；Carotid intima-media thickness；Thiazolidinediones；Atherosclerosis 2型糖尿病患者动脉粥样硬化常始于糖尿病发生之前。早期发现动脉粥样硬化、了解其程度、及时干预治疗可防止糖尿病并发症，降低糖尿病心脑血管疾病的死亡率。噻唑烷二酮类药物通过激活细胞内过氧化物酶增殖活化受体γ（PPARγ）提高靶组织对胰岛素的敏感性，同时改善B细胞产生胰岛素的能力，被应用于2型糖尿病的治疗。颈动脉内膜中层厚度（IMT）是反映早期动脉粥样硬化的无创性指标。本研究以IMT观察为终点，评价噻唑烷二酮类药物罗格列酮对早期2型糖尿病患者动脉粥样硬化进展的影响。 1 对象与方法 1.1研究对象 初诊2型糖尿病为我院内分泌科门诊及住院患者91例，其中，男43例，女48例，年龄28～65（47±8）岁，体重指数BMI（25.2±3.1） kg/m2。纳入标准：①符合1999年WHO糖尿病的诊断和分型标准。②新诊断的2型糖尿病，未使用胰岛素或磺脲类药物治疗。③排除各种糖尿病急性并发症、感染、严重肝肾功能损害、自身免疫