二甲双胍对2型糖尿病血管内皮功能的影响

目的：研究二甲双胍对2型糖尿病血管内皮功能的影响。方法93例血糖控制不满意的2型糖尿病患者随机分为二甲双胍组（500nag，3次／d）及吡格列酮组（15mg，1次／d），疗程12个月。观察血管内皮功能的变化。结果与治疗前相比，治疗12个月后两组患者的血糖、胰岛素抵抗指数均显著下降，空腹及餐后胰岛素水平、胰岛素功能均显著升高，差异具有统计学意义（均P〈0．05）。治疗12个月后两组血糖、胰岛素抵抗指数、胰岛素水平、胰岛素功能比较，差异均无统计学意义（均P〉0．05）；但治疗12个月后二甲双胍组的体质量指数低于吡格列酮组，差异具有统计学意义（P〈0．05）。与治疗前相比，治疗12个月后两组患者的血管内皮功能均显著改善，差异具有统计学意义（均P〈0．05），但治疗12个月后二甲双胍组的血管内皮功能改善优于吡格列酮组，差异具有统计学意义（P〈0．05）。结论二甲双胍与吡格列酮两种药物对2型糖尿病患者均具有明显的降糖、改善胰岛素功能、降低胰岛素抵抗及改善血管内皮功能的作用。在降低体质量指数及改善血管内皮功能方面，二甲双胍优于吡格列酮。

Metformin effects on endothelial function in type 2 diabetes

Objective To study mefformin effects on endothelial function in type 2 diabetes. Methods 93 cases of dissatisfaction glycemic control in patients with type 2 diabetes were randomly assigned to mefformin group （500 mg,3 times/d）and pioglitazone group（ 15 rag, l/d）, the course of 12 months. Then observe the changes of vascular endothelial function. Results Compared with those before treatment,patients blood sugar,insulin resistance index were lower than those after 12 months of treatment, fasting and postprandial insulin levels, insulin function index were higher than those after 12 months of treatment, and the difference was statistically significant（ all P 〈 0. 05 ）. After 12 months of treatment, the difference of blood glucose, insulin resistance index, insulin levels, insulin function between two groups was not statistically significant（ all P 〉 O. 05 ）. But after 12 months of treatment, body mass index in mefformin group was less than those in pioglitazone group, the difference was statistical significance （P 〈0. 05）. Compared with those before treatment, vascular endothelial function in both group was better after 12 months of treatment than that before treatment, and the difference was statisticaUy significant （all P 〈 0.05）. But after 12 months treatment, endothelial function in mefformin group was better than that in pioglitazone group, and the difference was statistically significant （ P 〈 0.05 ）. Conclusion Both mefformin and pioglitazone in patients with type 2 diabetes have significantly hypoglycemic, improve insulin function, reduce the role of insulin resistance and improve endothelial function. In the lower body mass index and improve endothelial function, mefformin is better than that of pioglitazone.