罗格列酮联合胰岛素治疗2型糖尿病疗效及心血管安全性观察

目的探讨罗格列酮治疗2型糖尿病的临床疗效及心血管安全性。方法选取2008年3月-2011年3月医院收治的2型糖尿病患者120例,随机分为2组,每组60例。治疗组60例给予马来酸罗格列酮4mg,每天1次,并联合精蛋白锌生物合成人胰岛素注射液预混30R治疗;对照组60例给予精蛋白锌生物合成人胰岛素注射液预混30R治疗,根据血糖要求调整个体化的胰岛素给药剂量。每3个月监测患者体质量、血压、血糖、糖化血红蛋白（Hb A1c）、血脂、心电图及心脏彩超,监测期为2年,数据进行统计分析。结果治疗后,治疗组合并原发性高血压患者血压下降,与对照组差异显著（P〈0.05）;治疗组未合并高血压患者下降不明显。治疗组治疗后空腹血糖（FBG）、餐后血糖（2h PG）、Hb A1c、三酰甘油（TG）与治疗前比较明显下降（P〈0.01）,与对照组比较有显著差异。用药24个月中,监测心电图及心脏彩超均合格,治疗过程患者无明显不良反应。结论罗格列酮联合生物合成人胰岛素30R治疗2型糖尿病,能显著降低2型糖尿病并原发性高血压患者血压,降低患者FBG、2h PG、Hb A1c、三酰甘油（TG）,其临床疗效同样确切,甚至更优,且心血管系统不良反应小,安全性好。

Clinical observation on the efficacy and cardiovascular security of rosiglitazone together With insulin treated tyPe 2 di-abetes mellitus

Objective Discusse the clinical efficacy and cardiovascular security of type 2 diabetes mellitus using Rosiglitazone. Methods 120 patients with type 2 diabetes mellitus were chosen as samples from March,2008 to March,2011. 60 patients in treatment group were treated by 4mg qd rosiglitazone maleate together with protamine and zinc photosynthesis human insulin injection,which was premixed for 30 R. On the other hand,60 patients in control group were treated by protamine and zinc photosynthesis human insulin injection only,which was premixed for 30 R,and the individual drug dosage of insulin was adjusted according to glucose requirement. Results The SBP and DBP values of patients with type 2 diabetes mellitus and essential hypertension in treatment group was significantly different comparing with that in control group（ P 〈0. 05）; The decrease of patients without hypertension in treatment group was not significant. The FBG,2h PG and Hb A1 c of patients in treatment group decreased significantly comparing to that before treatment（ P 〈0. 01）. It was significan difference comparing to control group. During the 24 months treatment period,the monitoring ECG and Echocardiography of patients was qualified,and the patients has no significant adverse reactions. Conclusions When the patients with type 2 diabetes mellitus was treated using Rosiglitazone,the blood pressure of patients with essential hypertension can be decreased significantly,and the patients ＇FBG,2h PG,Hb A1 c and TG was decreased,the clinical efficacy was also reliable,and even better,there is little adverse reactions in cardiovascular system,and the security is high.