循环酶法试剂盒测定血清总胆汁酸的差异

目的探讨循环酶法胆汁酸(TBA)试剂盒的差异及其基质效应.方法 6种TBA试剂盒(以A～F表示)各自用其所带校准品定标,测定其批内与批间精密度和部分试剂的线性,并检测20份浓度介于2.85～104.6 μmol/L之间的新鲜血清与4个厂家生产的9种质控品;其中3种试剂再改用日本第一化学药品株式会社(简称日本一化)的校准品进行定标并测定前述标本,以日本一化的结果作为参照体系,比较其结果的差异.结果 6种试剂中有4种试剂的批内与批间精密度<5.0%,B、D试剂的批间精密度分别达6.90%和7.48%;A、C、D、F 4种试剂的线性范围均比其说明书标示值有所降低;C、D、E、F测定新鲜血清TBA的结果与日本一化差异无显著性(P>0.05),而B相差较大(P<0.001).用日本一化的校准品为C、D、F定标后重新检测20份新鲜血清,C测定结果与日本一化差异无显著性,但F测定结果与日本一化差异有显著性(P<0.05),而D测定结果平均上升40%(P<0.001).B、D、F测定9个质控品的结果,其中7个均比日本一化高出1倍.结论各厂家的第5代循环酶法TBA试剂盒质量参差不齐,部分试剂的基质效应明显,校准品靶值转移亦可能存在问题.应选用质量较好的试剂盒,避免出现严重的系统误差.     

循环酶法试剂盒测定血清总胆汁酸的差异

目的　探讨循环酶法胆汁酸 (TBA)试剂盒的差异及其基质效应。方法　 6种TBA试剂盒 (以A～F表示 )各自用其所带校准品定标 ,测定其批内与批间精密度和部分试剂的线性 ,并检测 2 0份浓度介于 2 .85～10 4 .6 μmol/L之间的新鲜血清与 4个厂家生产的 9种质控品 ;其中 3种试剂再改用日本第一化学药品株式会社(简称日本一化 )的校准品进行定标并测定前述标本 ,以日本一化的结果作为参照体系 ,比较其结果的差异。结果　 6种试剂中有 4种试剂的批内与批间精密度 <5 .0 % ,B、D试剂的批间精密度分别达 6 .90 %和 7.4 8% ;A、C、D、F 4种试剂的线性范围均比其说明书标示值有所降低 ;C、D、E、F测定新鲜血清TBA的结果与日本一化差异无显著性 (P >0 .0 5 ) ,而B相差较大 (P <0 .0 0 1)。用日本一化的校准品为C、D、F定标后重新检测 2 0份新鲜血清 ,C测定结果与日本一化差异无显著性 ,但F测定结果与日本一化差异有显著性 (P <0 .0 5 ) ,而D测定结果平均上升 4 0 % (P <0 .0 0 1)。B、D、F测定 9个质控品的结果 ,其中 7个均比日本一化高出 1倍。结论　各厂家的第 5代循环酶法TBA试剂盒质量参差不齐 ,部分试剂的基质效应明显 ,校准品靶值转移亦可能存在问题。应选用质量较好的试剂盒 ,避免出现严重的系统误差。     

比较与评价4种同型半胱氨酸生化试剂的性能

目的评价4种用于同型半胱氨酸(Hcy)检测的生化试剂(A、B、C、D)在同一全自动生化分析仪器上的性能。方法对4种Hcy生化试剂的重复性进行评估;将A试剂设为对比试剂,其余3种设为实验试剂,进行相关性分析;应用4种生化试剂分别测定3个厂家提供的试剂配套质控品的Hcy值并计算相对偏差。结果 4种Hcy生化试剂测定同份混合血清的变异系数分别为2.57%、6.12%、2.29%、3.78%;B、C、D试剂与A试剂测定的相关系数分别为0.535 5、0.931 9、0.957 7。4种Hcy试剂分别测定厂家提供的配套质控品Hcy值的相对偏差如下,A:-7.84%~13.57%,B:-19.29%~9.47%,C:-13.94%~6.67%,D:7.86%~27.37%。结论 A、C、D试剂均有较好精密度;B试剂与A试剂的相关性较差,C、D试剂与A试剂的相关性较好;A、C试剂具有较好准确性。A试剂的性能指标要优于其他3种试剂。     

3种视黄醇结合蛋白生化试剂的比较和评价

目的了解3种视黄醇结合蛋白(RBP)生化试剂(A,B,C)在同一台生化分析仪上的检测结果是否具有可比性。方法先检测仪器及视黄醇结合蛋白(RBP)生化试剂重复性,再以B试剂为比较试剂,其他两种为试验试剂,对49例测定结果进行相关分析。然后用RBP试剂分别测定自身及其他厂家的两种试剂质控品,与靶值比较计算相对偏差。结果 3种RBP生化试剂(A,B,C)测定同一份混合血清的变异系数分别为0.87%、1.15%、2.90%。3种生化试剂新鲜血清RBP测定结果相关系数(A,C与B比较)分别为0.962 1、0.972 6。3种生化试剂测定质控品,与靶值比较计算相对偏差分别为:A试剂(-40.38%～3.26%);B试剂(-8.75%～18.14%);C试剂(28.38%～67.78%)。结论 A、B、C试剂精密度都较好,但B试剂与其他试剂比较测定质控品的相对偏差较小,因此总体显示B试剂性能指标优于其他两种试剂。     

血液流变定值质控物对测定结果的影响

目的 研究血液流变定值质控物对测定值的影响.方法 使用三批不同含量的定值质控物(A、B、C)进行黏度检测,测定血液黏度项目200s-1、50s-1、1s-1.结果 三批不同含量的定值质控物与测定值比较,定值质控物A相对偏差-8.88%、-8.15%、-5.80%,B相对偏差-3.31%、-4.0%、-5.40%,C相对偏差-10.37%、-11.59 %、-14.4%.经统计分析,质控物A均为P＜0.001,质控物B为P＜0.05、P＜0.05、P＜0.01,质控物C均为P＜0.001.结论 定值质控物测定值偏向同一侧,存在系统误差.必须对仪器进行检测校准,同时要定期对血流变仪监测.观察仪器有无漂移.保证结果 的准确性.     

30℃条件下血浆和血清粘度随切变率的变化

目的观察30℃条件下血浆和血清粘度随切变率的变化。方法对从38名健康人(18~23岁)中采集的全血、血浆和血清用LIANG-100型细管式粘度仪在30℃土0.5℃条件下测试切变率分别为10s-1、20s-1、40s-1、70s-1和110s-1的粘度,比较不同切变率下的血浆、血清和全血粘度。结果血浆、血清和全血三种血液组份的粘度均随切变率的降低而升高,呈现与全血相似的粘度曲线,其110s-1切变率粘度、40-1切变率粘度及10s-1切变率粘度间具有显著性差异(P<0.01)。结论在30℃下,血浆和血清表现为粘度切变依赖性的非牛顿流体特性。     

NCCLS EP5-A2在全自动血液流变分析仪精密度评价中的应用

目的 应用NCCLS EP5-A2文件对MVIS-2040全自动血液流变仪进行精密度性能评价.方法 参考NCCLS EP5-A2文件有关要求,用MVIS-2040全自动血液流变仪对全血高黏、全血中黏、全血低黏3种浓度的质控样品分别进行全血高切(200 s-1)、全血中切(30 s-1)、全血低切(3 s-1)及血浆黏度检测,根据检测数据算出各项目批内、批间、日间及室内精密度值并进行评价.结果 3种浓度质控样品各检测项目的 批内、批间、日间及室内精密度值均小于5%.结论 本实验室使用的MVIS-2040全自动血液流变仪精密度好,能满足临床实验要求.     

血液Casson屈服应力在血液粘度质控中的应用--患者结果均值法

目的探讨并建立血液粘度测定的质量控制方法。方法计算患者血液Casson屈服应力,并将其引入患者结果均值质控法,用Levey-Jennings质控图来综合判断每日(批)患者为单位的血液粘度测定的质量。结果432例患者血液Casson屈服应力的数据呈正态分布;患者低切粘度(1s-1)数据与对应Casson屈服应力相关系数r=0.929。患者血液低切粘度(1s-1)数据与对应Casson屈服应力数据配对两样本均数比较,P<0.001;质控图设警告界限为6.45±0.74mPa,控制界限为6.45±0.98mPa。结论将Casson屈服应力引入“患者结果均值法”,其质控方法有效可行。     

进口配套γ谷氨酰转移酶检测系统测定结果精密度和正确度调查

目的 调查国内临床实验室使用的6个系列进口配套γ谷氨酰转移酶(GGT)检测系统测定结果的精密度和正确度,为实验室酶学测定确定具有准确性的目标系统提供依据.方法 国内两家候选酶学参考实验室使用国际临床化学和检验医学联合会(IFCC)推荐的GGT参考测量方法,为5个活性浓度水平的新鲜冰冻混合人血清确定靶值,实验人员用基于厂家配套校准品等方式校准的6个厂家配套检测系统对血清样本进行检测,每个厂家均由独立分布于5个实验室的5台仪器组成(其中1个厂家为2台),各台仪器于实验前由各厂家工程师进行了一次日常维护.收集检测数据,统计同一厂家检测系统、不同厂家检测系统间检测结果的精密度,及各厂家检测系统测定结果均值与参考方法靶值的偏倚.结果 6个厂家(A、B、C、D、E、F)配套测定系统间5个水平检测结果的差异为16.1%～35.4%;不同检测系统间5个水平样本测定结果的变异系数(CV)为5.3%～8.8%;同厂家配套检测系统间5个水平样本测定结果CV分别为A:2.17%～5.07%、B:4.21%～10.98%、C:0.52%～2.38%、D:1.35%～2.59%、E:0.23%～1.54%、F:1.83%～2.38%.各厂家测定系统检测结果均值与靶值的偏倚分别为A:0.43%～8.41%、B:-1.49%～-13.04%、C:11.2%-17.73%、D.0.19%～4.62%、E:-0.30%～-2.63%、F:-0.46%～7.90%.调查显示:有2个厂家结果在本次调查的浓度范围内偏倚均小于1/4美国<临床实验室改进法案修正案>(CLIA'88)规定的允许总误差(TAE);有2个厂家结果在特定浓度范围内偏倚可满足1/4 TAE;有2个厂家结果的偏倚在大多数情况下近于或大于1/2 TAE.调查同时显示:在高、低浓度水平,有半数以上调查厂家结果的偏倚大于1/4 TAE.结论 不同厂家配套检测系统间结果的均值存在明显差异,其结果的可比性明显劣于同一厂家检测系统间的可比性;厂家应进一步保证其检测系统经参考方法校正,并应注重对检测系统测定线性的校正.     

自配3M低泡多酶清洗液与原配清洗液在ZL9000PLUS全自动血液流变测试仪上的应用效果比较

[目的]探讨为节省血液流变学指标的检测成本,改原配清洗液为自配清洗液的应用效果.[方法]采用自配的3M低泡多酶清洗液和原配套清洗液,清洗旋转式血液粘度计切液锥和测试池.比较两种清洗液本底蒸馏水表观粘度值(D=120s-1,T=37℃)及临床标本使用两种清洗液在仪器设定的三种切变率(D=5s-1,30s-1,120s-1)下的全血粘度检测结果.[结果]原配组本底试验蒸馏水粘度值精确度(CV) 为2.16%;自配组CV为 2.07%.两组清洗液本底试验稳定,其差异无显著性(P>0.05);在全血标本测定后测定蒸馏水粘度值,原配清洗液组测试蒸馏水粘度值CV 2.73%;自配清洗液组测试蒸馏水粘度值CV2.37%,两样本均数的t检验无显著性差异(P>0.05);临床标本使用两种清洗液在仪器设定的三种切变率下的全血粘度检测结果差异均无显著性(P>0.01).[结论]自配3M多酶低泡清洗液,可以替代原装配套清洗液,并能保证ZL9000PLUS全自动血液流变测试仪的精度.     

Variations of whole blood viscosity using Rheolog-a new scanning capillary viscometer

BACKGROUND: Whole blood viscosity (WBV) values identify subjects at high risk for initial or recurrent cardiovascular events. However, these measurements have been limited to specialized centers. A new type of viscometer, Rheolog, was designed to overcome the difficulties encountered in WBV measurements using the standard rotational viscometer in a clinical environment. METHODS: We evaluated the 14-day variability of WBV measured by Rheolog in a single-center study of 24 healthy male subjects aged 18-75 years. WBV was measured through an 11-h period on study days 1, 8, and 14. An additional fasting WBV test was performed on study days 3, 5, and 11. RESULTS: Average morning measurements were higher than afternoon measurements at all shear rates. Both inter- and intraindividual variations were higher in the morning than later in the day, but the differences between pooled mean values were not significant. Interindividual variations at fasting were higher than the pre-meal or overall variations. There was a small nonsignificant increase in mean viscosity following each meal. CONCLUSION: WBV measurements using Rheolog have potential for clinical application because of the convenience and low variability of measurements over time.     

2型糖尿病患者胰岛素泵强化治疗后皮下注射胰岛素3种方式的疗效比较

目的观察比较2型糖尿病患者短期胰岛素泵(CSII)强化治疗血糖达标后改为皮下注射,分别转换成预混胰岛素70/30每天早晚餐前皮下注射,人胰岛素R及人胰岛素N 4次皮下注射及甘精胰岛素与门冬胰岛素4次皮下注射,观察血糖达标率,血糖控制情况及低血糖发生率。方法对本科2009年12月~2011年12月2型糖尿病患者CSII治疗7~10 d血糖达标者分为3组,预混胰岛素70/30每天2次早晚餐前皮下注射治疗组(A组),人胰岛素R及人胰岛素NPH四次皮下注射组(B组),甘精胰岛素与门冬胰岛素四次皮下注射组(C组),比较转换胰岛素治疗后3组的血糖达标率,低血糖发生率,日内血糖波动幅度。结果血糖达标率B组与C组差异无统计学意义,B组高于A组,C组高于A组;低血糖发生率C组低于A组(P<0.05),A组与B组差异无统计学意义,B组与C组差异无统计学意义,日内血糖波动3组之间差异无统计学意义。结论 3种治疗方式均能使血糖达标,可以获得相似的血糖控制状态,B组与C组治疗较A组血糖达标率高,低血糖发生率低,临床有较好的有效性及安全性。     

Effect of Whole-Body Vibration Exercise on Power Profile and Bone Mineral Density in Postmenopausal Women With Osteoporosis: A Randomized Controlled Trial

ObjectiveThe purpose of this study was to investigate the effect of whole-body vibration (WBV) on muscle work and bone mineral density (BMD) of the lumbar vertebrae and femur in postmenopausal women.MethodsForty-three postmenopausal women with low BMD were randomly assigned to WBV and control groups. Both groups received calcium and vitamin D supplementations once daily, while the WBV group additionally received WBV exercise (twice/wk) for 24 successive weeks. Qualisys gait analysis system was used to measure hip power generation by hip extensors (H1S) and flexors (H3S), hip power absorption by hip flexors (H2S), knee power absorption by quadriceps during loading response (K1S) and preswing (K3S), knee power absorption by hamstring (K4S), knee power generation by quadriceps (K2S), ankle power absorption by dorsiflexors (A1S) and plantar flexors (A2S), and ankle power generation by plantar flexors (A3S). Also, dual-energy X-ray absorptiometry was used to measure BMD of the lumbar vertebrae and femur before and after the intervention.ResultsThere were significant increases (P < .05) in the hip muscle work (H1S, H2S, and H3S), knee muscle work (K1S, K2S, K3S, and K4S), ankle muscle work (A1S, A2S, and A3S) during gait, and BMD of the lumbar vertebrae and femur of the WBV group. However, there were no significant changes (P > .05) in the control group. The posttreatment values of the hip, knee, and ankle muscle work and BMD of the WBV group were significantly (P < .05) higher than the posttreatment values of the control group.ConclusionWhole-body vibration training improved the leg muscle work and lumbar and femoral BMD in postmenopausal women with low BMD.     

不同剂量酒精对大鼠心肌组织的影响

目的观察不同剂量酒精对大鼠心肌组织的影响。方法 140只健康SD大鼠随机分成7组:正常对照组及不同剂量酒精模型组0.8 mL/(kg.d)(A组),1.6 mL/(kg.d)(B组),2.4 mL/(kg.d)(C组),3.2 mL/(kg.d)(D组),4.0 mL/(kg.d)(E组),4.8 mL/(kg.d)(F组),每组20只,雌雄各半。正常组给予10 mL/(kg.d)生理盐水灌胃,其余分别给予53度赖茅酒灌胃,每周灌胃6次,连续灌胃4个月,16周后每组大鼠禁食12 h,取颈总静脉血检测肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)、超敏C反应蛋白(hs-CRP)。处死大鼠取心肌组织进行组织病理学检查。结果模型A、B组与正常对照组比较,CK-MB、cTnT水平无明显变化,差异无统计学意义(P>0.05);模型C、D、E、F组与正常对照组及模型A、B组比较CK-MB、cTnT水平明显升高,差异有统计学意义(P<0.01)。模型A、B组与正常对照组相比hs-CRP水平明显降低,差异有统计学意义(P<0.05);模型D、E、F组与正常对照组相比hs-CRP水平明显升高,差异有统计学意义(P<0.05);正常对照组、模型C、D、E、F组与A、B组比较hs-CRP水平明显升高,差异有统计学意义(P<0.05)。模型D、E、F组可见心肌间质水肿,心肌细胞变性、坏死;模型A、B、C组心肌组病理改变与对照组比较差异无统计学意义。结论适量饮酒可降低hs-CRP,保护心肌细胞,过量饮酒[>2.4 mL/(kg.d)]可导致心肌损伤标志物水平升高及心肌细胞组织病理学改变。     

感染HBV或HCV的肝病患者血清半胱氨酸蛋白酶抑制剂C的改变

目的探讨血清半胱氨酸蛋白酶抑制剂C（Cystatin C）在感染HBV或HCV肝病患者中的临床应用。方法测定了207例HBV或者HCV感染的肝病患者和32名健康对照组（H组）中Cystatin C和金属蛋白酶组织抑制剂（TIMPs）浓度。肝病患者被分成肝硬化组（A组，67例）、慢性乙肝组（B组，73例）、慢性丙肝组（C组，39例）和肝癌组（D组，28例）。结果受试者Cystatin C、TIMP-1和TIMP-2在各组间差异均有统计学意义（F值分别为28．234、128．091、196．549，P值均〈0．001）。Cystatin C与TIMPs在各肝病组中的变化一致：肝病组均显著高于健康对照组，A组和D组均显著高于B组与C组，A组与D组、B组与C组间均差异无统计学意义。Pearson相关分析显示Cystatin C与TIMP-1在各肝病组中均呈明显正相关，且有显著性差异；但Cystatin C与TIMP-2的相关性仅A组（r=0．269，P〈0．05）和D组（r=0．398，P〈0．05）呈正相关，有显著性差异，而B组（r=-0．102，P〈0．05）和C组（r=-0．107，P〈0．05）则呈负相关，且差异无统计学意义。结论血清胱抑素C可能是监测肝脏功能的有用指标。     

Analytical performance evaluation of the scanning capillary tube viscometer for measurement of whole blood viscosity

BackgroundWhole blood viscosity (WBV) is the resistance of blood flow in blood vessels. Increased WBV may be a cardiovascular risk factor. The proper screening of WBV can help the early detection of cardiovascular disease. We investigated the performance of a new scanning capillary tube viscometer (SCTV) for the measurement of WBV.MethodsWe evaluated the total precision of the SCTV for 20 days using three control viscosity materials, and the within-day precision with the whole blood samples of three different individuals. For the linearity evaluation, serial dilutions of a high concentration standard material were used. For the method comparison, the results of the SCTV method were compared to those of Brookfield rotating viscometer on 227 subjects.ResultsThe SCTV had good within-run and total-run coefficient of variant (CV)s at low-, medium-, and high-concentration samples, at shear rates of 1 and 300 s^? 1. The within-day CVs with the three human blood samples were 6.3%, 3.7% and 3.8% at a shear rate of 1 s^? 1, and 3.2%, 3.0% and 4.1% at a shear rate of 300 s^? 1. The SCTV method showed an excellent linearity in the range of 84.9 to 558.2 milliPoise (mP) and 28.8 to 71.0 mP at shear rates of 1 and 300 s^? 1, respectively. For the comparison study, the SCTV and the rotating viscometer showed comparable results.ConclusionsThe SCTV showed a stable analytical performance, and was comparable with the rotational viscometer. This new SCTV method can be used in the clinical laboratory for various needs.     

去白细胞库存血流变特性观察

目的：观察去除白细胞（WBC）库存血流变特性的变化。方法：选择60例健康献血员,随机分为A、B两组,A组为去WBC组,B组为对照组。应用去白细胞输血滤过器去除WBC,常规保存。取新鲜血（采集后1小时）1周、2周及3周4个时相点,进行WBC、RBC计及全血高切粘度、低切粘度、血浆粘度、血球压积及RBC聚集指数（AI）和刚性指数（IR）检测。结果：滤过后WBC显著减少,P＜0.01,在3周保存时间内,WBC、RBC计数、红细胞压积无显著变化,两组高切粘度在第三周显著升高,而低切粘度下降。血浆粘度、AI和IR随保存时间延长进行性下降。两组间比较在第3周AI存在显著差异（P＜0.05)。结论：滤过能有效降低血液中的WBC,去除WBC库存血可能有利于保护RBC的聚集性,但对血液粘度及RBC变形性无显著影响。     

Efficacy and safety of glimepiride/metformin sustained release once daily vs. glimepiride/metformin twice daily in patients with type 2 diabetes

Aims: The study investigated the clinical equivalence in reducing haemoglobin A1c (A1C) between glimepiride/metformin sustained release (GM‐SR) 2/500 mg, a fixed‐dose combination, once daily and glimepiride/metformin (GM) 1/250 mg, a fixed‐dose combination, twice daily in patients with type 2 diabetes (T2D). Methods: A multicentre, randomised, double‐blind, double‐dummy study was conducted in 14 hospitals in Korea. Inclusion criteria were age 30–75 years, T2D diagnosis no longer than 10 years previously, A1C between 7% and 10%, and body mass index < 40 kg/m². A total of 207 subjects were randomised into the GM‐SR group (n = 101) or the GM group (n = 106). Participants were assessed at baseline, 8 weeks and 16 weeks after treatment. Results: After 16 weeks treatment, no difference in baseline‐adjusted changes of A1C (primary efficacy variable) was observed between the two groups (?0.59% for GM‐SR group vs. ?0.61% for GM group, 95% CI: ?0.17 to 0.21; p = 0.84). In addition, there were no significant differences in secondary efficacy parameters between the two groups, including changes in A1C up to week 8, changes in fasting plasma glucose (FPG) and 2‐h‐postprandial plasma glucose up to week 8 and week 16, response rate, drug compliance and hypoglycaemic events. However, there was a difference in baseline‐adjusted changes of FPG between the two groups (?1.01 mmol/l for GM‐SR group vs. ?1.52 mmol/l for GM group, p = 0.01 in the intention to treat set). Conclusions: GM‐SR 2/500 mg once daily was as effective as GM 1/250 mg twice daily in lowering A1C. In addition, no difference was noted in hypoglycaemic events between the two groups.     

减重步行训练结合针刺治疗对脊髓损伤大鼠运动功能及Cdh1 mRNA表达的影响

摘要 目的：探讨减重步行训练结合针刺治疗对脊髓损伤（SCI）大鼠运动功能及Cdh1 mRNA表达的影响。 方法：将150只雄性SD大鼠随机分为针刺组（A）、步行训练组(B)、针步组（C）、对照组（D）,每组30只,及假手术组（E）、空白组（F）,每组15只。A、B、C、D组采用切割型脊髓损伤模型法制备SCI模型;E组仅暴露脊髓。并于术后3d开始A、B、C组相应治疗,D、E不予治疗,F组不做任何处理。术后3、5、7、14、21d对大鼠后肢运动功能进行BBB评分;及提取脊髓损伤节段组织总RNA,用实时荧光定量测定PCR检测损伤区Cdh1 mRNA的表达。 结果：21d后治疗组BBB评分明显高于D组,其中C组最高,B组次之,A组最少,各组差异有显著性（P<0.01）;Cdh1 mRNA的表达C组最高,与其他各组有显著差异（P<0.01）;A、B组与D组相比差异有显著性（P<0.01）,A、B组差异无显著性（P>0.05）。 结论：减重步行训练或针刺治疗都对SCI大鼠运动功能及损伤部Cdh1 mRNA的表达具有良性作用,二者结合疗效更为显著。     

Evaluation of glipizide and glyburide in a health maintenance organization.

OBJECTIVE: To determine if there was a difference in the long-term glycemic control, average daily dose, and cost of therapy in patients with noninsulin-dependent diabetes mellitus (NIDDM) treated with glyburide and glipizide in a health maintenance organization (HMO). DESIGN: Retrospective evaluation of medical and pharmacy records. SETTING: Multispecialty group practice HMO. PATIENTS: 140 NIDDM patients being treated with either glyburide (n = 70) or glipizide (n = 70) were randomly selected from the populations of patients receiving either drug using computerized pharmacy records. MAIN OUTCOME MEASURE: Mean daily doses and blood glucose measurements (fasting blood glucose, random blood glucose, hemoglobin A1C) were stratified in 3-month periods from the time the drug therapy was started or the patient first presented to the clinic for a total of 18 months. Long-term glycemic control was defined as fasting blood glucose less than 8.33 mmol/L (150 mg/dL). RESULTS: The groups were comparable with regard to age (53.4 y glyburide, 56.7 y glipizide), gender (43 M:27 F glyburide, 47 M:23 F glipizide), race (38 W/16 B/16 H glyburide, 45 W/16 B/9 H glipizide), concurrent medical conditions, adverse effects, and compliance. Long-term glycemic control was similar in both groups. Although the number of subjects who were controlled (by definition) tended to be greater in the glyburide group, no clinical or statistical difference was found. There was no statistical difference in mean daily dose between the ethnic groups, but the small numbers preclude further analysis. The glipizide group had a larger percentage increase in dose within the first year than did the glyburide group; however, the percentage increase from the 3-month dose was similar after 18 months (22.7 percent glyburide, 27.5 percent glipizide.) Average daily cost of therapy, based on mean daily dose, was slightly lower for glyburide-treated patients. CONCLUSIONS: If glycemic control is similar with glyburide and glipizide, as seen in this study, economic considerations regarding choice of therapy and formulary inclusion may be appropriate.