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目的观察罗格列酮和胰岛素对治疗磺脲类降糖药继发性失效患者的胰岛功能改善的比较。方法选择60例磺脲类降糖药继发性失效的2型糖尿病患者,分为胰岛素组、罗格列酮组及胰岛素联合罗格列酮组,治疗24周,治疗前后分别测糖化血红蛋白(HbA1 c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FIns)、血脂三酰甘油(TG)、胆固醇(TG)高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体重指数(BM I)、HOMA-IR、HOMA-IS、ISI、△I30△/G30。结果HbA1 c、FPG、2hPG、HOMA-IR、治疗后三组均明显下降,有统计学意义(P<0.05),HOMAβ胰岛细胞分泌指数、ISI治疗后三组均明显升高,有统计学意义(P<0.01);△I30△/G30治疗前后的差值罗格列酮组及胰岛素联合罗格列酮组与胰岛素组比较有统计学意义(P<0.01),而罗格列酮组及胰岛素联合罗格列酮组之间比较差异无统计学意义(P>0.05)。结论本研究表明罗格列酮有助于诱导β细胞功能的恢复,这种作用与纠正葡萄糖毒性作用无关。
Objective To observe the effects of rosiglitazone and insulin on the improvement of pancreatic islet function in patients with secondary failure of sulfonylurea hypoglycemic agents. Methods Sixty patients with type 2 diabetes mellitus secondary to failure of sulfonylurea were randomly divided into insulin group, rosiglitazone group and insulin plus rosiglitazone group for 24 weeks. Before and after the treatment, the levels of glycosylated hemoglobin HbA1 c, FPG, 2 hPG, FIns, TG, HDL-C, Lipoprotein cholesterol (LDL-C), body mass index (BM I), HOMA-IR, HOMA-IS, ISI, △ I30 △ / G30. Results After HbA1c, FPG, 2hPG and HOMA-IR, the three groups were significantly decreased (P <0.05), the secretion index of HOMAβ islet cells after ISI treatment increased significantly, with statistical significance (P <0.01). The differences between before and after △ I30 △ / G30 treatment were statistically significant (P <0.01), while those in rosiglitazone group and insulin combined with rosiglitazone group were higher than those in insulin group There was no significant difference between insulin and rosiglitazone group (P> 0.05). Conclusion This study shows that rosiglitazone can help to induce the recovery of β-cell function, which has nothing to do with the correct role of glucose toxicity.