格列齐特缓释片对2型糖尿病患者血管功能的影响

目的观察格列齐特缓释片对2型糖尿病(T2DM)患者血管功能的影响。方法72例T2DM患者随机均分为对照组(口服格列齐特片,80 mg／次,每日2次)和试验组(口服格列齐特缓释片,60 mg／次,每日1次),疗程为12周。采用高分辨率超声测定肱动脉内皮依赖性血管舒张功能(FMD)和硝酸甘油介导的非内皮依赖性血管舒张功能(GNTMD)的变化,并测定血清一氧化氮(NO)及内皮素-1(ET-1)的水平。同时选择40名年龄和性别相匹配的健康志愿者(正常组)作为基线对照。结果与正常组比较,治疗前试验组和对照组的血清ET-1水平显著升高(P值均<0.01),血清NO水平及GNTMD、FMD值显著下降(P值均<0．01)。与治疗前比较,治疗12周后试验组和对照组血清ET-1水平显著降低(P值均<0．01),NO水平和GNTMD、FMD值显著上升(P值均<0．01)。试验组和对照组均能有效降低空腹和餐后2 h血糖及糖化血红蛋白水平,差异均有统计学意义(P值分别<0．05、0．01)。结论格列齐特缓释片和普通片可在有效降低T2DM患者血糖的同时,改善血管内皮功能。

Effects of slow-release gliclazide on vascular function in treatment of Chinese patients with type 2 diabetes mellitus

Objective To compare the effects of gliclazide and slow-release-gliclazide on vascular function of brachial artery in treatment of Chinese patients with type 2 diabetes mellitus. Methods Seventy two Chinese type 2 diabetic patients were allocated into slow-release gliclazide group(60 mg/d, 12 weeks, n = 36) or gliclazide(160 mg/d, 12 weeks, n = 36) group in a randomized, double masked, double blind manner. Endothelial function of brachial artery in 72 diabetics and 40 normal controls were studied by high resolution ultrasonography. The serum levels of nitric oxide (NO) and endothelin-1 (ET-1) were also measured. Results The changes of both flow-mediated endothelium-dependent dilatation (FMD) and glyceryltrinitrate-mediated endothelium-independent dilatation (GNTMD) in brachial arteries at baseline of the two diabetic groups decreased significantly comparing with those of normal controls. Both FMD and GNTMD increased in diabetics after 12-week treatment. In slow-release gliclazide group the mean increments of both FMD and GNTMD were 3. 16% and 2% respectively. In gliclazide group the mean increments of both FMD and GNTMD were 3. 07% and 2% respectively. The serum levels of baseline ET-1 in the two groups increased) but nitric oxide decreased significantly comparing with that of the normal controls. The serum levels of ET-1 decreased, but nitric oxide increased after 12-week treatment. HbA1c,fasting and postprandial plasma glucose levels in the two groups were significantly reduced after 12-week treatment in comparison with the baseline values. No serious adverse events in the two groups occurred. The differences in the above parameters between the two groups were not statistically significant. Conclusions Both gliclazide and slow-released gliclazide can improve the endothelial functional dependent dilatation and serum glucose level in type 2 diabetics.