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目的探讨吡格列酮对2型糖尿病(T2DM)患者尿单核细胞趋化蛋白1(MCP-1)排泄的影响及意义。方法 90例T2DM患者随机分为吡格列酮干预组(DP组,44例)和磺酰脲类药物干预组(DS组,46例),观察12周,测定治疗前后两组的FBG、HbA_1c水平及UAlb/Cr(UACR)和尿MCP-1/Cr比值(UMCR)。结果 (1)基础时,两组指标差别无显著性;(2)治疗后两组FBG和HbA_1c均明显降低(P<0.01),但两组间无显著性差别;两组UMCR均明显降低(P<0.01和0.05),DP组UACR明显降低(P<0.01),DS组UACR轻度降低(P>0.05);与DS组相比较,DP组UACR和UMCR显著降低(P<0.05);(4)DM组患者UMCR水平与HbA_1c(r=0.652,P<0.01)和UACR(r=0.695,P<0.01)呈正相关。结论吡格列酮可能减轻肾组织局部增强的炎症反应,对糖尿病肾损伤提供保护作用。
Objective To investigate the effect of pioglitazone on the excretion of urinary monocyte chemoattractant protein-1 (MCP-1) in type 2 diabetes mellitus (T2DM) and its significance. Methods Ninety patients with T2DM were randomly divided into two groups: pioglitazone intervention group (44 cases) and sulfonylurea intervention group (46 cases). The levels of FBG, HbA 1c and UAlb / Cr (UACR) and urine MCP-1 / Cr ratio (UMCR). Results (2) The FBG and HbA 1c in both groups were significantly lower (P <0.01) after treatment, but there was no significant difference between the two groups; the UMCR in both groups were significantly lower (P < UACR in DP group was significantly lower than that in DS group (P <0.01 and P <0.05). UACR in DP group was significantly lower than that in DS group (P <0.01) 4) The UMCR level in DM group was positively correlated with HbA 1c (r = 0.652, P <0.01) and UACR (r = 0.695, P <0.01). Conclusion Pioglitazone may reduce locally enhanced inflammatory reaction in renal tissue and provide a protective effect on diabetic renal injury.