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目的 探讨罗格列酮 (RSG)联合胰岛素 (INS)治疗单用INS血糖控制不佳的老年 2型糖尿病 (DM)患者的临床疗效及安全性。方法 将 68例单用INS疗效不佳的老年 2型DM患者随机分为两组各 3 4例 :对照组继续使用合适剂量的胰岛素治疗 ;治疗组在原剂量胰岛素的基础上加服RSG 4mg/d共 2 0周。观察治疗后 4周及 2 0周患者的空腹血糖 (FBG)、餐后 2h血糖 (PBG)、糖化血红蛋白 (HbA1c)、2 4h尿白蛋白排泄率 (UAER)、每日INS用量变化及药物的不良反应等。结果 治疗组 4周后FBG、PBG下降 (P均 <0 0 5 ) ,治疗 2 0周后以上指标下降更显著 ,并使HbA1C、UAER、舒张压、TG及平均每日INS用量下降 ,差异具显著性 (P均 <0 0 5 ) ;对照组治疗后血糖及HbA1c也有一定下降 ,但INS需要量及低血糖发生率明显增加。结论 RSG确实能有效改善老年 2型DM患者的血糖控制 ,治疗安全有效。该药还能改善代谢综合征的一些异常 ,从而对心血管起到保护作用
Objective To investigate the clinical efficacy and safety of rosiglitazone (RSG) combined with insulin (INS) in elderly patients with type 2 diabetes mellitus (DM) with poor blood glucose control. Methods A total of 68 elderly patients with type 2 diabetes mellitus (DM) with single-use INS were randomly divided into two groups (34 in each): the control group continued to receive the appropriate dose of insulin; the treatment group received RSG 4 mg / d on the basis of the original dose of insulin A total of 20 weeks. The levels of fasting blood glucose (FBG), postprandial 2h blood glucose (PBG), HbA1c, 24 h urinary albumin excretion rate (UAER), daily INS dosage changes, Adverse reactions. Results The FBG and PBG in the treatment group decreased after 4 weeks (all P <0 05). After 20 weeks of treatment, the above indexes decreased more significantly and the HbA1C, UAER, diastolic blood pressure, TG and the average daily INS dosage decreased (P <0.05). The levels of blood glucose and HbA1c in the control group also decreased to a certain extent, but the INS requirement and the incidence of hypoglycemia were significantly increased. Conclusion RSG can effectively improve glycemic control in elderly type 2 DM patients and the treatment is safe and effective. The drug can also improve some of the abnormal metabolic syndrome, which play a protective role on the cardiovascular