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吡格列酮或胰岛素治疗对2型糖尿病患者血尿酸的影响

刘媛媛1,谢晓娜2,朱栗文2   

  1. 1. 高邮市人民医院
    2. 吉林大学第一医院
  • 收稿日期:2011-07-19 修回日期:2011-12-22 出版日期:2012-09-15 发布日期:2012-09-15
  • 通讯作者: 朱栗文

  • Received:2011-07-19 Revised:2011-12-22 Published:2012-09-15 Online:2012-09-15

摘要: 目的:比较吡格列酮或胰岛素治疗对2型糖尿病患者( type 2 diabetes mellitus T2DM)血糖及血尿酸的影响。方法:133名2型糖尿病合并高尿酸血症的患者随机分为3组,监测12周治疗前后空腹血糖、餐后2h血糖、糖化血红蛋白、血尿酸、肌酐、总胆固醇和甘油三酯。结果:吡格列酮组治疗后空腹血糖、餐后2h血糖、糖化血红蛋白、血尿酸、甘油三酯、总胆固醇等均较治疗前下降(P<0.05)。胰岛素治疗组空腹血糖、餐后2h血糖、HbA1c均较治疗前显著下降(P<0.05)。胰岛素组治疗前后空腹血糖、餐后2h血糖和HbA1c均低于吡咯列酮和常规治疗组(P<0.05)。吡格列酮组降低尿酸的作用显著高于胰岛素治疗组。常规治疗组降低血尿酸作用高于吡咯列酮组和胰岛素组。结论:胰岛素组的降糖作用最强。吡格列酮显著降低血尿酸。对于2型糖尿病合并高尿酸血症,无痛风的患者,宜选用吡格列酮。

关键词: 吡格列酮, 胰岛素治疗, 2型糖尿病, 高尿酸血症

Abstract: Abstract Objective:To compare the effects of pioglitazone or insulin therapy on blood glucose and serum uric acid in type 2 diabetes.Method: one hundred and thirty-three patients with type 2 diabetes mellitus complicated with hyperuricemia randomly divided into 3 groups.Fasting glucose, 2-hour glucose, glycation hemoglobin(HbA1c), serum uric acid, microalbuminuria(MAU), serum creatinine(Cr), total cholesterol(TC) and triglyceride(TG) were measured before and after 12 weeks of treatment with pioglitazone, insulin or conventional treatment. Results:Fasting glucose, 2-hour glucose, HbA1c, serum uric acid, TC and TG decreased significantly at 12 weeks in patients receiving pioglitazone(P<0.05). Fasting glucose, 2-hour glucose and HbA1c decreased significantly at 12 weeks in patients receiving insulin(P<0.05).At 12 weeks, the insulin group had lower fasting glucose, 2-hour glucose and HbA1c, than the pioglitazone group and the insulin group(P<0.05). The pioglitazone group had lower serum uric acid than the insulin group .(P<0.05). The conventional treatment.group had lower serum uric acid than the other group(P<0.05). Conclusions:Insulin lead to a decrease on blood glucose decrease; pioglitazone lead to adecrease on serum uric acid.For type 2 diabetes who also have hyperuricemia, without gout,pioglitazone is a better choice.

Key words: pioglitazone, insulin therapy, type 2diabetes, hyperuricemia