二甲双胍治疗糖尿病67例疗效观察及对同型半胱氨酸及甲基丙二酸水平影响.docVIP

二甲双胍治疗糖尿病67例的疗效观察及对同型半胱氨酸及甲基丙二酸水平的影响 　　摘 要 目的：探讨二甲双胍治疗糖尿病的疗效及对同型半胱氨酸（Hcy）、甲基丙二酸（MMA）水平的影响。方法：选取2014年1月―2016年5月期间我院确诊治疗的糖尿病患者134例，依据随机分配原则分为二甲双胍组和对照组各67例，对照组患者予以常规治疗，二甲双胍组患者在此治疗基础上给予二甲双胍治疗，统计分析所有患者治疗效果以及血清总胆固醇（TC）、甘油三酯（TG） 、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）水平，并采用生化分析仪检测血清中Hcy、MMA、维生素B12（VitB12）水平。结果：二甲双胍组患者治疗有效率、MMA、TC、TG、HDL、LDL水平明显高于对照组（P0.05），而血清中Hcy、VitB12水平则明显低于对照组（P0.05）。结论：二甲双胍可有效提高糖尿病治疗的疗效并改善患者血清中Hcy、血脂水平，但可引起MMA水平升高，具有导致多系统损害的风险，应同时给予VitB12治疗。 　　关键词 二甲双胍 糖尿病 同型半胱氨酸 甲基丙二酸 　　中图分类号：R597.1； R977.15 文献标识码：A 文章编号：1006-1533（2016）21-0023-03 　　Efficacy of metformin in the treatment of 67 cases of patients with diabetes and its effect on the levels of homocysteine and methylmalonic acid 　　ZHANG Na（Department of Endocrinology and Rheumatology， Division Two， The People’s Hospital of Jiangxi Province， Nanchang 330006， China） 　　ABSTRACT Objective： To discuss the efficacy of metformin in the treatment of patients with diabetes and its effect on the levels of homocysteine （Hcy） and methylmalonic acid （MMA）. Methods： One hundred and thirty-four cases of patients with diabetes were selected and randomly divided into a metformin group and a control group with 67 cases each. The control group underwent conventional treatment while the metformin group was additionally treated with metformin besides the conventional treatment. The efficacy and the levels of TC， TG， HDL， LDL， Hcy， MMA and VitB12 were statistically analyzed. Results： The effective rates and the levels of MMA， TC、TG、HDL and LDL were significantly higher while the levels of serum Hcy and VitB12 were significantly lower in the metformin group than in the control group （P0.05）. Conclusion： Metformin can effectively improve the efficacy of diabetes treatment and the serum Hcy and lipid levels. However， metformin can cause the increase of the serum MMA level with the risk of multi-system damage， so such patients should also be given VitB12 treatment. 　　KEY WORDS metformin； diabetes； homocysteine； methylmalonic acid 　　2型糖尿