格列美脲对2型糖尿病患者心血管保护作用临床观察

目的：观察格列美脲对2型糖尿病患者心血管的保护作用并探讨其可能的机制。方法：112例T2DM患者随机分为格列美脲组（格列美脲＋二甲双胍）和对照组（格列本脲＋二甲双胍）,观察治疗前后两者空腹及餐后两小时血糖（FBG,2hPBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、HOMA模型胰岛素抵抗指数（HOMA-IR）、甘油三脂（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、同型半胱氨酸（HCY）、血浆脂联素的变化。结果：两组患者的TC、LDL-C、TG、FBG、2hPBG都较治疗前降低,连续服用6个月以上格列美脲的T2DM患者其血浆HCY、HOMA-IR、血糖水平明显下降,血浆脂联素水平明显升高,与对照组相比差异有统计学意义（P〈0.05）。结论：格列美脲能降低多项心血管危险因子水平,对血脂、HCY和动脉粥样硬化都有良性调节作用,其作用基础可能与改善胰岛素抵抗,增加血浆脂联素相关。

The Clinical Observation on Cardiovascular Protective Effect of Glimepiride on Patients with Type 2 Diabetes Mellitus

Objective：To observe the protective effects and to explore mechanisms of glimepiride on cardiovascular system of Type 2 Diabetes Mellitus.Methods：112 patients with type 2 diabetes mellitus were randomly divided into treatment group （glimepiride combined with metformin） and control group （glibenclamide combined with metformin）.The fasting blood glucose （FBG）,2hPBG,hemoglobin A1c （HbA1c）,FINS,HOMA-IR,blood lipid （TC,TG,LDL-C and HDL-C）,HCY （homocysteine） and adiponectin were detected before and after treatment.Results：In all cases,the level of TC、LDL-C、TG、FBG、2hPBG were decreased after treated with glimepiride or glibenclamide combined with metformin for 6 monthes.Moreover,the level of HCY,HOMA-IR and blood glucose were decreased and the level of adiponectin was increased significantly than that of in control group （P〈0.05）.Conclusion：Glimepiride showed the effective on decreasing the risk factor of cardiovascular system disease with regulation of blood lipid,HCY,and improve the atherosclerosis.The effective of glimepiride on cardiovascular system was relation to improved the insulin resistance and increase the adiponectin.