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目的:了解不同糖耐量老年人内皮细胞功能状态以及罗格列酮治疗后的变化。方法:选择正常对照、IFG、IGT及2型糖尿病病人4组老年人,应用罗格列酮(4mg/d,12周)治疗并观察内皮功能指标:C反应蛋白(CRP)、肿瘤坏死因子(TNF)、尿白蛋白排泄率(UAER)、I型血浆纤溶酶原活化抑制剂(PAI-1)、假性血友病因子(vWF)、血浆血栓调节蛋白(TM)的变化和大血管并发症的危险因素-胰岛素抵抗水平的情况。结果:IFG、IGT及2型糖尿病组的CRP、TNF、UAER、PAI-1、TM、vWF水平均较对照组差异有统计学意义(P<0.05或P<0.01)。2型糖尿病组的CRP、TNF、UAER、PAI-1、TM、vWF较IFG、IGT组差异有统计学意义(P<0.05或P<0.01)。上述指标经罗格列酮治疗后呈不同程度的下降,治疗前后差异有统计学意义(P<0.05)。血脂水平也有所改善。结论:罗格列酮可以调节炎症因子稳定血管内皮功能,也可以改善胰岛素抵抗所致的内皮功能障碍,进而减少心脑血管等并发症。
Objective: To understand the functional status of endothelial cells in elderly patients with different glucose tolerance and the changes after treatment with rosiglitazone. Methods: Four elderly patients with normal control, IFG, IGT and type 2 diabetes mellitus were selected and treated with rosiglitazone (4 mg / d for 12 weeks). Endothelial function indexes such as C-reactive protein (CRP), tumor necrosis factor TNF, UAER, PAI-1, vWF, TM, and macrovascular Risk factors for complications - Insulin resistance levels. Results: The levels of CRP, TNF, UAER, PAI-1, TM and vWF in IFG, IGT and type 2 diabetic patients were significantly different from those in control group (P <0.05 or P <0.01). The levels of CRP, TNF, UAER, PAI-1, TM and vWF in type 2 diabetic patients were significantly different from those in IFG and IGT patients (P <0.05 or P <0.01). The above indexes decreased with rosiglitazone treatment, the difference was statistically significant before and after treatment (P <0.05). Blood lipid levels have also improved. Conclusion: Rosiglitazone can regulate inflammatory factors to stabilize vascular endothelial function, and can also improve endothelial dysfunction caused by insulin resistance, thereby reducing complications such as cardiovascular and cerebrovascular diseases.