脂联素在急性肾损伤模型大鼠的变化及吡格列酮的干预研究*

目的：观察脂联素在顺铂诱导的急性肾损伤模型大鼠中的变化及吡格列酮干预后的研究。方法：将清洁级雄性SD大鼠随机分为对照组(A组)、单纯吡格列酮处理组(B组)、急性肾损伤模型组(C组)、不同吡格列酮剂量干预组(D组、E组、F组),每组各5只。C、D、E、F组予单次腹腔注射顺铂注射液(10 mg/kg)进行造模。成功后B、D、E、F组分别予不同剂量吡格列酮连续灌胃3 d[10、5、10、15 mg/(kg?d)],观察大鼠饮食、精神、活动等。48 h后各组大鼠眼球取血行血清学检查。72 h后各组大鼠予水合氯醛腹腔注射,眼球取血检测血清脂联素,肾组织行病理检查,免疫组织化学法检测各组大鼠肾组织Caspase3表达。结果：与A组相比,C、D、E、F组大鼠血肌酐、尿素氮、血清脂联素明显升高(P＜0.05),Caspase3表达增加(P＜0.01),HE染色显示肾间质及肾小管损伤加重。给予不同剂量吡格列酮干预后,D、E、F组大鼠组织病理学损伤减轻,血肌酐、尿素氮下降(P＜0.05),血清脂联素升高更显著(P＜0.05),肾组织Caspase3表达降低(P＜0.05),且这些改变具有浓度依赖性趋势,其中E、F组改变更明显(P＜0.05)。相关分析显示血清脂联素与Caspase3表达呈负相关(P＜0.05)。结论：吡格列酮干预后可减轻急性肾损伤模型大鼠肾小管间质病变,改善肾功能,其机制可能与提高血清脂联素水平,从而抑制肾组织Caspase3的表达有关。     

Rational therapy for diabetes: early recognition of adverse effects and avoidance of disruptive false alarms

Corresponding to the uncontrolled diabetes pandemic, significant effort has been invested in developing new therapeutic options. Nevertheless, all medicines have possible adverse effects. Recently, a trend of 'scrutinizing' novel hypoglycaemic drug side effects based on scant scientific data has emerged. With recent publications highlighting possible dangers of rosiglitazone, insulin glargine, sitagliptin, exenatide and, most recently, pioglitazone, it seems that all means are valid and that every database is suitable, even if specifically defined as inadequate for the purpose of data analysis. The use of such data may lead authors to draw erroneous conclusions that may be granted unwarranted impact upon publication in leading scientific journals and eventually lead patients and misinformed physicians to wrongly change beneficial medication regimes. Adherence to strict scientific methodology, ongoing large clinical trials and creating adjudicated patient databases may facilitate early recognition of adverse effects while avoiding disruptive false alarms.     

盐酸吡格列酮干预治疗糖耐量减退的疗效观察

目的 :观察盐酸吡格列酮对葡萄糖耐量减退 (IGT)的干预作用。方法 :选择 IGT患者 6 0例 ,将其随机分成 2组 ,治疗组予吡格列酮片 1 5 m g,每天 1次。对照组不予吡格列酮。观察期间均进行糖尿病防治知识宣教 ,根据个体情况制定饮食及运动方案 ,为期 1年。结果 :1治疗组餐后 2 h血糖 (2 h PG )、空腹胰岛素 (FINS)、Hb A1 c、胆固醇 (CHOL )、胰岛素抵抗指数HOMA- IR较对照组下降 (P<0 .0 5 ,P<0 .0 1 ) ;2治疗组糖尿病发生率为 6 .9% ,对照组糖尿病发生率为 33.3% ,两组比较 ,差异有统计学意义 (P <0 .0 5 ) ;3多因素比例风险模型回归分析显示基线 2 h PG、体重指数 (BMI)、HOMA- IR与糖尿病发病呈独立正相关 ,吡格列酮治疗与糖尿病发病呈独立负相关。结论 :吡格列酮对 IGT干预治疗可明显降低糖尿病发生率