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1.
目的 观察利拉鲁肽对超重及肥胖2型糖尿病患者体质量和胰岛素抵抗的影响。方法 选取安徽医科大学第二附属医院2012年6月至2014年1月住院治疗的2型糖尿病患者,将口服药物血糖控制不佳且体质量指数(BMI)≥24 kg/m2的90例2型糖尿病患者按系统随机化法分成治疗组(45例)和对照组(45例),对照组在原方案上加用基础胰岛素,治疗组加用利拉鲁肽,治疗组根据BMI进一步分为超重亚组(BMI<28 kg/m2)24例,和肥胖亚组(BMI≥28 kg/m2)21例,连续治疗12周。比较治疗后各项指标(BMI、收缩压、空腹血糖、餐后血糖等)变化。结果 治疗组BMI及稳态模型胰岛素抵抗指数(HOMA-IR)治疗后较治疗前显著降低(P<0.05),对照组治疗后增加(P<0.05);收缩压(SBP)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖基化血红蛋白(HbA1C)、三酰甘油(TG)、总胆固醇(TCH)在两组中均较前下降(P<0.05),治疗组SBP、TG、TCH下降优于对照组(P<0.05),FBG、2 h PG、HbA1C下降,组间差异无统计学意义(P>0.05);治疗组中肥胖亚组BMI下降程度优于超重亚组(P<0.05);治疗过程中两组均未发生严重低血糖。结论 利拉鲁肽在降糖的同时也可以降低患者体质量并改善患者胰岛素抵抗;随着BMI增加,利拉鲁肽降低体质量及改善胰岛素抵抗作用越强。  相似文献   

2.
目的 探讨门冬胰岛素联合地特胰岛素对新诊断2型糖尿病(T2DM)患者血糖和胰岛β细胞功能的影响。方法 选取西电集团医院2017年1月-2018年12月收治的100例新诊断T2DM患者为研究对象,按就诊顺序分为两组,每组50例。对照组采取地特胰岛素皮下注射,观察组采取门冬胰岛素联合地特胰岛素皮下注射。对比两组用药对新诊断T2DM患者血糖和胰岛β细胞功能的影响。结果 两组治疗前空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)对比无统计学差异;经治疗,观察组各项血糖指标均明显下降(P<0.05),下降幅度明显优于对照组(P<0.05)。两组治疗前空腹血清C肽(FC-P)、餐后2 h血清C肽(2 h C-P)对比无统计学差异;经治疗,观察组的FC-P、2 h C-P明显提高(P<0.05),且高于对照组,具有统计学差异(P<0.05);观察组血糖达标时间明显短于对照组(P<0.05)。两组治疗前胰岛β细胞功能指数(HBCI)对比无统计学差异,治疗后,观察组HBCI明显高于对照组,具有统计学差异(P<0.05)。结论 对于新诊断T2DM患者,采取门冬胰岛素联合地特胰岛素治疗可有效控制血糖,促使胰岛β细胞功能恢复,治疗效果显著,值得临床上进一步推广应用。  相似文献   

3.
目的 探讨不同口服降糖药联合胰岛素对糖尿病患者胰岛β细胞功能、骨代谢和成本效果的影响,为临床治疗提供参考依据。方法 选取西安市第一医院2015年3月—2018年3月收治100例糖尿病患者,根据入院先后顺序随机分为观察组和对照组,每组50例,两组患者于每晚睡觉前皮下注射胰岛素,起始剂量为0.2 U/(kg·d),并停用其他降糖药物。观察组患者在此基础上,口服沙格列汀片5 mg/次,1次/d。对照组患者口服格列美脲片1 mg/次,1次/d,两组均连续治疗12周。对比两种不同口服降糖药物对糖尿病患者胰岛β细胞功能、骨代谢和成本的影响。结果 两组患者治疗前胰岛β细胞(Homaβ)、修正胰岛β细胞分泌指数(MBCI)、早期胰岛素分泌指数(EISI)、血糖曲线下面积(AUCglu)、胰岛素曲线下面积(AUCins)和C肽曲线下面积(AUCcp)对比无显著性差异;治疗后,两组的Homaβ、MBCI、EISI、AUCins和AUCcp水平在治疗后显著升高,而AUCglu水平治疗后显著降低,同组治疗前后比较差异均有统计学意义(P<0.05);且观察组治疗后Homaβ、MBCI、EISI、AUCins和AUCcp水平显著高于对照组,而AUCglu水平显著低于对照组,组间差异均有统计学意义(P<0.05)。两组患者经不同用药方案治疗后的骨密度均明显改善,与同组治疗前相比具有统计学差异(P<0.05),而与对照组相比,观察组患者的骨密度改善程度更加明显,组间差异有统计学意义(P<0.05)。两组患者治疗后血糖的控制情况空腹血糖(FPG)、餐后2 h血糖(2h PG)和糖化血红蛋白(HbA1C)比治疗前均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组治疗后FPG、2h PG和HbA1C均显著低于对照组治疗后(P<0.05)。观察组患者降糖药物成本低于对照组,但两种治疗方案药物成本对比无统计学差异。结论 糖尿病患者采取口服沙格列汀降糖药物联合胰岛素治疗方案是可行的,可结合患者具体特点,在早期应用药物,改善患者的胰岛β细胞功能,改善骨代谢,控制血糖水平,延缓糖尿病进展,经济效果较佳,可减轻患者的经济负担。  相似文献   

4.
目的 探讨沙格列汀联合胰岛素泵短期强化降血糖治疗对2型糖尿病患者β细胞分泌功能及胰岛素抵抗的影响。方法 选择上海市奉贤区中心医院2017年5月-2018年5月收治的101例2型糖尿病患者,根据随机数字表法分为观察组(52例)及对照组(49例)。对照组给予胰岛素泵短期强化治疗,观察组在对照组基础上给予二肽基肽酶Ⅳ(DPP-4)抑制剂沙格列汀,两组治疗疗程均为2周。对比两组患者临床疗效、治疗前后的血糖相关指标、胰岛素β细胞功能变化、血糖达标时间、胰岛素日用量、低血糖发生率及血糖达标率。结果 治疗后,观察组总有效率为88.5%,显著高于对照组的73.5%(P<0.05)。治疗后,两组的空腹血糖(FPG)、餐后2 h血糖(2 h PG)均明显低于治疗前,胰岛β细胞功能指数(HOMA-β)、C肽水平(C-p2)均明显高于治疗前,同组治疗前后比较差异均有统计学意义(P<0.05);且治疗后观察组的C-p2明显高于对照组(P<0.05)。对照组的胰岛素抵抗指数(HOMA-IR)治疗前后对比无统计学意义;治疗后观察组的HOMA-IR明显低于治疗前和对照组,差异有统计学意义(P<0.05)。观察组的血糖达标时间及胰岛素日用量明显低于对照组,血糖达标率明显高于对照组,组间差异有统计学意义(P<0.05)。两组低血糖发生率对比无统计学意义。结论 沙格列汀联合胰岛素泵短期强化降血糖治疗2型糖尿病可更快、平稳的控制血糖,更好的改善胰岛β细胞分泌功能及胰岛素抵抗。  相似文献   

5.
相晓梅  吕晓芳 《药学研究》2022,41(9):621-624
目的 探讨沙格列汀联合盐酸二甲双胍治疗糖尿病的临床分析疗效,对胰岛β细胞保护作用和糖化血红蛋白(HbA1c)的达标率分析。方法 将我院2018年6月至2021年6月137例糖尿病患者分组,按照简单随机数字表法分为对照组(n=68)和观察组(n=69),对照组采用盐酸二甲双胍治疗,观察组立足于对照组基础上采用沙格列汀治疗。评估两组糖尿病患者的临床疗效,比较患者的血清胰岛素(Ins)、C肽、餐后2 h血糖(PBG)、空腹血糖(FBG)、糖化血红蛋白、不良反应发生情况。结果 观察组总有效率为95.65%,高于对照组的83.82%(P<0.05);与治疗前相比,治疗后两组胰岛素、C肽水平均上升,且观察组高于对照组(P<0.05);与治疗前相比,治疗后两组餐后2 h血糖、空腹血糖、糖化血红蛋白水平均下降,且观察组低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 沙格列汀联合盐酸二甲双胍治疗糖尿病患者具有明显的临床疗效,可提高胰岛素、C肽水平,降低餐后2 h血糖、空腹血糖、糖化血红蛋白水平,对胰岛β细胞起到保护作用,患者出现不良反应的概率较少,用药较为安全可靠。  相似文献   

6.
目的 探讨杞黄降糖胶囊联合利拉鲁肽注射液治疗血糖控制不佳的2型糖尿病的临床疗效。方法 选取新乡市中心医院2021年11月至2022年5月收治的85例2型糖尿病患者。采用随机数字表法将85例2型糖尿病患者分为对照组(42例)和治疗组(43例)。对照组皮下注射利拉鲁肽注射液,起始0.6 mg/次,1次/d,1周后无不良反应则加量至1.2 mg/次。在对照组的基础上,治疗组口服杞黄降糖胶囊,6粒/次,3次/d。两组患者均治疗12周。观察两组的临床疗效,比较两组生活质量、血糖指标和胰岛素相关指标。结果 治疗后,对照组的总有效率为73.81%,治疗组的总有效率为93.02%,治疗组的总有效率高于对照组(P<0.05)。治疗后,两组的生存质量量表(DMQLS)各维度评分均下降(P<0.05),且治疗组DMQLS各维度评分均低于对照组(P<0.05)。治疗后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)均下降(P<0.05),且治疗组FBG、2 h PG、HbAlc均低于对照组(P<0.05)。治疗后,两组胰岛素(FINS)、稳态模型胰岛β细胞分泌指数(HOMA-β)、稳态模型胰岛素抵抗指数(HOMA-IR)均升高(P<0.05),且治疗组FINS、HOMA-β、HOMA-IR均高于对照组(P<0.05)。结论 杞黄降糖胶囊联合利拉鲁肽注射液治疗血糖控制不佳的2型糖尿病可促进患者生活质量提升,有效控制血糖,改善胰岛素水平。  相似文献   

7.
摘 要 目的:观察利拉鲁肽治疗2型糖尿病(T2DM)合并肥胖患者的降糖及减重作用,探讨合并肥胖的T2DM新的治疗思路。方法: 超重和肥胖的T2DM患者38例,入组前口服降糖药物或应用胰岛素治疗血糖控制不达标,按体质指数(BMI)分为两组,A组为超重组(BMI 24~28 kg·m-2)18例、B组为肥胖组(BMI≥28 kg·m-2)20例,两组均加用利拉鲁肽治疗12周,观察治疗前后两组患者身高、体质量和BMI;2 h空腹和餐后2 h血糖(FPG,2hPG)、糖化血红蛋白(HbA1c),空腹(FINS)和餐后2 h胰岛素(2hINS)、空腹(FCP)和餐后2 hC肽(2hCP);以及胰岛素抵抗指数(HOMA IR)和胰岛β细胞分泌功能指数(HOMA β)。结果: 治疗后两组患者的HbA1c、FBG、2hPG、FCP、2hCP及HOMA β、HOMA IR等指标均较治疗前明显改善(P<0.01);两组上述指标组间比较无明显差异(P>0.05)。治疗后B组患者体质量和BMI较治疗前下降明显(P<0.01),而A组体质量和BMI无明显改变(P>0.05)。结论: 超重和肥胖T2DM患者,加用利拉鲁肽治疗后,可有效地控制血糖,改善胰岛素抵抗,而肥胖患者体质量较治疗前有明显下降。  相似文献   

8.
孙茜  张伟  韩洁 《现代药物与临床》2022,37(6):1319-1323
目的 探讨消糖灵胶囊联合利拉鲁肽治疗肥胖2型糖尿病的临床疗效。方法 选择2019年12月—2021年6月在河北中石油中心医院治疗的120例肥胖2型糖尿病患者,随机分为对照组和治疗组,每组各60例。对照组早餐前皮下注射利拉鲁肽注射液,0.6 mg/次,1次/d。治疗组在对照组的基础上口服消糖灵胶囊,3片/次,2次/d。两组患者连续用药15周。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,血糖指标空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)和空腹血清胰岛素(FINS)水平,血清因子肿瘤坏死因子-α(TNF-α)、可溶性血管细胞黏附因子-1(Svcam-1)、白细胞介素-6(IL-6)和超敏C反应蛋白(hs-CRP)水平,及不良反应。结果 治疗后,治疗组总有效率为98.33%,明显高于对照组的83.33%(P<0.05)。治疗后,治疗组多饮、多食、多尿、口干缓解时间均明显早于对照组(P<0.05)。治疗后,两组患者FPG、2 h FPG、HbA1c、FINS指标和血清因子TNF-α、Svcam-1、IL-6、hs-CRP水平均明显下降(P<0.05),且治疗后治疗组这些指标明显低于对照组(P<0.05)。治疗期间,治疗组不良反应发生率为6.67%,明显低于对照组的13.33%(P<0.05)。结论 消糖灵胶囊联合利拉鲁肽治疗肥胖2型糖尿病效果确切,症状缓解明显,并能有效控制患者血糖,降低机体炎症反应。  相似文献   

9.
目的 探讨消渴清颗粒联合利格列汀治疗血糖控制不佳的2型糖尿病的临床疗效。方法 选择唐山市第八医院2018年4月-2019年11月收治的血糖控制不佳的2型糖尿病患者84例作为本实验对象,根据随机数字表法将患者分成对照组和观察组,每组各42例。对照组口服利格列汀片,5 mg/次,1次/d。观察组在对照组基础上温水冲服消渴清颗粒,6 g/次,3次/d。两组患者连续治疗16周。观察两组患者的临床疗效,同时比较两组治疗前后的血糖指标、体质量指数(BMI)、胰岛β细胞功能、细胞因子水平,录两组患者血糖达标时间。结果 观察组患者在治疗后的总有效率为95.24%,显著高于对照组的80.95%,差异有统计学意义(P<0.05)。治疗后,两组的空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、BMI均明显降低,差异有统计学意义(P<0.05);治疗后,观察组的BMI比对照组低(P<0.05)。治疗后,两组的胰岛素(INS)、胰岛素β细胞功能指数(HOMA-β)明显升高,胰岛素抵抗指数(HOMA-IR)明显降低(P<0.05);治疗后,观察组的INS、HOMA-β比对照组高,HOMA-IR比对照组低,差异有统计学意义(P<0.05)。治疗后,两组的白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)显著降低,脂联素(APN)显著升高(P<0.05);治疗后,观察组的IL-1β、IL-6、TNF-α比对照组低,APN比对照组高,差异有统计学意义(P<0.05)。治疗后,观察组患者的血糖达标时间比对照组短,差异有统计学意义(P<0.05)。结论 消渴清颗粒联合利格列汀可提高血糖控制不佳的2型糖尿病的疗效,提高血糖控制效率,可能与调节炎症因子分泌,改善胰岛β细胞功能有关。  相似文献   

10.
目的 探讨西格列汀联合预混胰岛素治疗脆性糖尿病伴高脂血症的疗效和安全性。方法 采用回顾性分析法,收集解放军180医院内分泌科门诊脆性糖尿病伴高脂血症患者158例,其中,单用预混胰岛素治疗的78例为对照组,西格列汀联合预混胰岛素治疗的80例为治疗组,随访时间为36周。比较两组治疗前后糖化血红蛋白(HbAlc)、空腹血糖(FPG)、餐后血糖(PPG)、空腹C肽、餐后2 h C肽,每日血糖谷峰浓度均差(△TP)、血脂水平变化及低血糖发生率。结果 治疗后联合组FPG、PPG、△TP、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)较治疗前均有明显下降(P<0.05,P<0.01),且均低于对照组(P<0.05,P<0.01);联合组空腹C肽和餐后2 h C肽较治疗前显著升高(P<0.01),且均高于对照组(P<0.05)。结论 西格列汀联合预混胰岛素治疗脆性糖尿病伴高脂血症可显著改善患者血糖和血脂水平,且不良反应更少。  相似文献   

11.
In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.  相似文献   

12.
Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (cmax, tmax, AUC) were calculated for plasma and tissue time courses. The mean AUCtissue /AUCplasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - tmax Time to peak concentration - cmax Peak concentration  相似文献   

13.
1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.  相似文献   

14.
本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。  相似文献   

15.
16.
Polymorphisms in genes involved in neurotransmission in relation to smoking   总被引:4,自引:0,他引:4  
Smoking behavior is influenced by both genetic and environmental factors. The genetic contribution to smoking behavior is at least as great as its contribution to alcoholism. Much progress has been achieved in genomic research related to cigarette-smoking within recent years. Linkage studies indicate that there are several loci linked to smoking, and candidate genes that are related to neurotransmission have been examined. Possible associated genes include cytochrome P450 subfamily polypeptide 6 (CYP2A6), dopamine D1, D2, and D4 receptors, dopamine transporter, and serotonin transporter genes. There are other important candidate genes but studies evaluating the link with smoking have not been reported. These include genes encoding the dopamine D3 and D5 receptors, serotonin receptors, tyrosine hydroxylase, trytophan 2,3-dioxygenase, opioid receptors, and cannabinoid receptors. Since smoking-related factors are extremely complex, studies of diverse populations and of many aspects of smoking behavior including initiation, maintenance, cessation, relapse, and influence of environmental factors are needed to identify smoking-associated genes. We now review genetic polymorphisms reported to be involved in neurotransmission in relation to smoking.  相似文献   

17.
18.
Diclofop-methyl (DM) is a chlorophenoxy derivative used in large quantities for the control of annual grasses in grain and vegetable crops. In this study, the genotoxic effects of DM were investigated by measuring chromosomal aberrations (CAs) in mouse bone-marrow cells and CA and the comet assay in human peripheral lymphocytes. Mice were treated with 15.63, 31.25, 62.5, and 125?mg/kg body weight of DM intraperitoneally for 24 hours, and 15.63-, 31.25-, 62.5-, 125-, and 250-µg/mL concentrations were applied to human lymphocytes for both 24 and 48 hours. In in vivo treatments, DM significantly, but not dose dependently, increased the total chromosome aberrations, compared to both negative and solvent controls. Cell proliferation was significantly, but not dose dependently, affected by all doses. In in vitro treatments, DM (except 15.63 µg/mL) significantly and dose dependently increased the frequency of chromosome aberrations. Also, 250 µg/mL of 48-hour treatment was found to be toxic. Cell proliferation was significantly and dose dependently affected by DM applications, when compared to negative control. In in vitro treatments, DM significantly decreased the mitotic index only at the highest concentration for 24 hours, and 62.5- and 125-µg/mL concentrations for 48 hours. In the comet assay, a significant and dose-dependent increase in comet-tail intensity was observed at 62.5-, 125-, and 250-µg/mL concentrations. The mean comet-tail length was significantly increased in all concentrations. Our results demonstrate that DM is genotoxic in mammalian cells in vivo and in vitro.  相似文献   

19.
2010调脂治疗领域进展   总被引:1,自引:0,他引:1  
2010年在调脂治疗领域针对他汀治疗心血管病的防治又进行了许多探索。本文通过综述他汀类药物的国际大规模临床试验结果,重新评价了他汀类药物在冠心病一级预防和冠心病二级预防中的地位,阐明了强化他汀治疗的意义;对他汀的心肾保护作用和安全性新证据进行了说明。  相似文献   

20.
Based on blood and cerebrospinal fluid samples collected in a full-term neonate, the penetration of tramadol in the central nervous system is described. Following intravenous administration of tramadol, a lag time of about 4 h was observed until full blood–brain equilibration was achieved. This pharmacokinetic observation is in line with a recent pharmacodynamic evaluation of the central opioid effects of tramadol in adults.  相似文献   

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