罗格列酮对2型糖尿病患者高血糖应激状态脂联素的影响

目的：观察2型糖尿病患者应激状态下血浆脂联素（APN）的变化，及应用罗格列酮（RSG）后对脂联素水平的影响。方法：我科2007年1月-2009年6月住院的2型糖尿病患者124例，合并高血糖应激的84例随机分为A、B两组（各42例），其他40例无急性并发症患者为C组。A、C组在B组降糖治疗基础上加用RSG 4mg·d^-1，B组无RSG的降糖治疗。观察治疗前后APN，C反应蛋白（CRP），皮质醇（COR），血糖（BG），糖化血红蛋白（HbA1C）等指标变化。结果：治疗前A、B两组APN浓度明显低于C组（P〈0．05），CPR及COR水平则明显高于C组（P〈0．05）。治疗后A组APN浓度较前明显升高（P〈0．05），且水平高于B组（P〈0．05），增加的幅度与C组相比差异无统计学意义（P〉0．05）；CRP、COR明显低于B组（P〈0．05），与C纽相比差异无统计学意义。三纽BG、HbA1C等水平差异无统计学意义。结论：2型糖尿病合并高血糖应激时APN水平明显减少，CRP、COR等拮抗胰岛素激素水平明显增高。RSG能显著增加高血糖应激状态时APN水平，并不依赖于血糖水平．从而减轻胰岛素抵抗。

Effects of Rosiglitazone on Adiponectin of Type 2 Diabetes When Stress Hyperglucose

Objective： To observe the change of APN of type 2 diabetes when stress hyperglucose and the effects of RSG on level of adiponectin. Method： One hundred and twenty-four patients with type 2 diabetes during January 2007 to June 2009 were selected, included 84 acute cases with stress hyperglucose, and divided them into two groups randomly ： group A （ n = 42 ）, group B （ n = 42 ） ; Group C （n = 40） was not hyperglucose acute cases. Patients in group A and C were given RSG 4 mg.d^-1 with other treatment of low- ering blood sugar while group B was treated without RSG. the change of CRP, COR, BG, and HbA1C were observed. Result： Before the treatment, APN of group A and B were evidently decreased than that of group C （ P 〈 0. 05 ）, CPR and COR levels were markedly higher than that of group C （ P 〈 0. 05 ）. After the treatment with RSG, APN of group A were increased remarkably （ P 〈 0. 05 ） ; CRP, COR of group A were obviously decreased than that of group B （ P 〈 0. 05 ）, but there were no significant differences of CRP and COR between group A and group C. BG and HbA1C of three groups were no remarkable differences. Conclusion： When strees hyperglucose, APN level of patients with type 2 diabetes mellitus markedly decreases. Levels of CRP and COR are getting higher obviously. The fact thai after the treatment with RSG, APN level will be much higher when patients are strees hyperglucose, the increase of APN concentration doesn＇ t rely on blood sugar level and therefore the insulin resistance can be reduced.