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目的通过比较糖尿病患者胰岛素联合罗格列酮治疗前后血浆醛固酮水平的变化,探讨罗格列酮导致水肿的机制。方法 2型糖尿病患者单独使用胰岛素治疗半年以上的患者随机分为两组,罗格列酮联合胰岛素治疗组在目前胰岛素治疗基础上加用罗格列酮4mg/日(n=10),胰岛素组继续胰岛素治疗(n=10)。分别于治疗前、治疗后2、4、6个月测定立位血浆醛固酮水平,监测患者水肿情况及体重。结果罗格列酮可以导致水肿、体重增加。罗格列酮联合胰岛素治疗组血浆醛固酮水平2个月时较对照组有升高的趋势(P>0.05);治疗4个月时显著高于对照组(P<0.05);至6个月时罗格列酮联合胰岛素治疗组血浆醛固酮水平较前下降,与胰岛素组无统计学差异(P>0.05)。结论罗格列酮治疗早期出现的水肿可能与血浆醛固酮水平升高有关。
Objective To investigate the mechanism of rosiglitazone-induced edema by comparing the changes of plasma aldosterone levels before and after treatment with insulin and rosiglitazone in diabetic patients. Methods Patients with type 2 diabetes mellitus who were treated with insulin alone for more than six months were randomly divided into two groups. Rosiglitazone combined with insulin treatment group was given rosiglitazone 4 mg daily (n = 10) on the basis of current insulin therapy, insulin group Insulin treatment was continued (n = 10). The level of plasma aldosterone was measured before treatment, 2,4,6 months after treatment, and the edema and body weight of the patients were monitored. Results Rosiglitazone can cause edema and weight gain. The level of plasma aldosterone in rosiglitazone combined with insulin group was higher than that in control group at 2 months (P> 0.05), and significantly higher than that in control group at 4 months (P <0.05). At 6 months The level of plasma aldosterone in rosiglitazone combined with insulin group was lower than that in the insulin group (P> 0.05). Conclusion Rosiglitazone treatment of early edema may be related to elevated plasma aldosterone levels.