阿卡波糖对餐后高血糖患者血管内皮功能的影响

目的研究阿卡波糖对餐后高血糖患者血管内皮功能的影响。方法选择新诊断为2型糖尿病、行口服葡萄糖耐量试验餐后高血糖患者58例,分为常规组26例和治疗组32例。检测患者治疗前后体重指数、TC、TG、LDL-C、HDL-C、空腹血糖、空腹胰岛素、糖化血红蛋白(HbA1c)、高敏C反应蛋白(hs-CRP)、血管性血友病因子(vWF)、葡萄糖耐量试验2 h血糖、2 h胰岛素及肱动脉内皮依赖性舒张功能(EDD)。结果与治疗前比较,治疗后2组患者体重指数、2 h血糖、2 h胰岛素、HbA1c、vWF明显降低,EDD明显增大(P0.05,P0.01);与常规组比较,治疗组患者2 h血糖、2 h胰岛素、HbA1c、hs CRP、vWF明显降低,EDD增大更明显(P0.05,P0.01)。多因素逐步回归分析显示,EDD与2 h血糖、2 h胰岛素、HbA1c、hs-CRP呈负相关。结论阿卡波糖可能通过降低餐后高血糖,改善机体胰岛素抵抗,使血管内皮功能得到改善,延缓动脉粥样硬化的发生、发展。

Influence of acarbose on vascular endothelial function in patients with postprandial hyperglycemia

Objective To study influence of acarbose on vascular endothelial function in patients with postprandial hyperglycemia.Methods Fifty-eight cases of postprandial hyperglycemia were chosen by OGTT from patients with newly diagnosed type 2 diabetic mellitus.They were divided into routine group and therapy group.All cases received examination of BMI,TC,TG,LDL-C, HDL-C,fasting blood glucose and insulin,HbA1c,hs-CRP,vWF,blood glucose and insulin of two hours during OGTT and brachial artery endothelium-dependent dilation(EDD).Results BMI. blood glucose and insulin of two hours during OGTT,HbAlc and vWF were decreased and brachial artery EDD were increased after treatment compared with before treatment (P < 0.05,P < 0.01).Furthermore,blood glucose and insulin of two hours during OGTT,HbA1c,hs-CRP.vWF and EDD of therapy group improved more significantly than those of routine group at the end (P <0.05,P < 0.01).Stepwise regression analysis showed that EDD was negatively correlated to blood glucose and insulin of two hours during OGTT,HbA1c and hs-CRP.Conclusion Acarbose can improve vascular endothelial function and delay atherosclerosis through decreasing postprandial hyperglycemia and increasing insulin sensitivity.