丹参注射液对维持性血液透析患者胰岛素抵抗作用的临床研究

目的观察丹参注射液对维持性血液透析患者胰岛素抵抗的作用并探讨其机制。方法将60例存在胰岛素抵抗的血液透析患者随机分为两组，治疗组在血液透析中使用0．9％氯化钠100ml加丹参注射液20ml静滴，而对照组则使用氯化钠120ml静滴，疗程为6个月。检测治疗前、后胰岛素抵抗指数以及血脂、肝功能及脂联素水平，并将胰岛素抵抗指数与脂联素行相关分析，监测不良反应。结果两组治疗前指标及胰岛素抵抗指数无明显差异，治疗组在治疗后脂联素水平升高，血脂和胰岛素抵抗指数显著降低，而对照组无显著改变。两组患者治疗前、后肝功能无明显变化，未监测到明显不良反应，胰岛素抵抗指数与脂联素呈负相关。结论丹参注射液可提高脂联素表达水平，改善胰岛素抵抗。

Effects of salvia injection on insulin resistance in patients with maintenance hemodialysis

Objective To observe the effect of salvia injection on insulin resistance in patients with maintenance hemodialysis（MHD）. Methods Sixty patients with insulin resistance in MHD were divided into two groups randomly. Patients in treatment group were administered with salvia injection at a dose of 20 ml combined with sodium chloride injection（100 ml） twice, and 120 ml sodium chloride injection was given in control group twice. Before and after 6 months, the serum adiponectin concentra- tion, insulin resistance index and clinical indexes（serum lipid and liver function） were determined. Cor- relation analysis was performed between adiponectin concentration and insulin resistance index. Side effects in the two groups were followed up. Results There was no significant difference in clinical in- dexes and insulin resistance indexes between the two groups before treatment. Serum adiponectin level in treatment group was increased obviously after treatment. Clinical indexes and homeostasis model as- sessment of insulin resistance in treatment group were decreased significantly in treatment group as compared with control group. There were no changes in above-mentioned indexes after treatment in control group. There was a negative correlation between adiponectin concentration and insulin resist- ance index. There was no significant difference in the liver function before and after treatment either in treatment group or control group. No obvious side effects were observed in two groups. Conclusions Salvia injection can improve insulin resistance of patients with MHD.