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目的 探讨应用磺脲类降糖药物格列吡嗪缓释片 (商品名瑞易宁 )及格列齐特 (商品名达美康 )对 2型糖尿病患者的胰岛 β细胞功能及胰岛素抵抗的影响。 方法 1 51名 2型糖尿病患者分为瑞易宁及达美康治疗组 ,测定治疗前后空腹血糖 (FPG) ,空腹血清免疫反应胰岛素 (IRI)、真胰岛素 (SI)、胰岛素原(PI)水平 ,计算PI占总胰岛素比例 ,并比较治疗前后HOMA模型中胰岛素抵抗指数 (HOMA IR)及 β细胞功能指数 (HOMA IS)的变化 ,分析血糖下降对胰岛素抵抗的影响。结果 (1 )两治疗组FPG均较治疗前有显著下降 ,两组间比较差异无显著性。 (2 )治疗后两组HOMA IS均有较明显上升 ,瑞易宁组上升 70 % ;达美康组上升 60 % ,但两组间比较差异无显著性。两组HOMA IR治疗后较治疗前均下降 ,瑞易宁组下降1 5 % ,达美康组下降 1 6 % ,但两组间比较差异无显著性。治疗后HOMA IR的下降与空腹及餐后血糖的下降相关。 (3)患者治疗前空腹PI水平为 (1 1 .93± 2 .2 7) pmol/L ,SI水平为 (55 .32± 1 .66)pmol/L ,PI的比例为 1 9.6 %。治疗后 ,服瑞易宁者空腹PI及SI水平均略有下降 ,但无统计学差异 ;服达美康者空腹血清PI及SI水平均略有上升 ,亦无统计学差异 ;PI在PI与SI总和中所占的比例与治疗前比较差异无显著性。结论 应用HOMA
Objective To investigate the effects of sulfonylurea drug glipizide sustained-release tablets (trade name Rui Yi Ning) and gliclazide (trade name DaMeikang) on pancreatic β-cell function and insulin resistance in type 2 diabetic patients. Methods Fifty-one patients with type 2 diabetes were divided into two groups: Re-Yi ning and Memecan group. Fasting plasma glucose (FPG), fasting serum immunoreactive insulin (IRI), real insulin (SI) and proinsulin (PI) The proportion of PI to total insulin was calculated. The changes of HOMA IR and HOMA IS in HOMA before and after treatment were compared to analyze the effect of blood glucose drop on insulin resistance. Results (1) FPG in both treatment groups decreased significantly compared with that before treatment, and there was no significant difference between the two groups. (2) After treatment, HOMA IS increased obviously in both groups, while in Ruifengning group increased by 70%; and that in Daymeikang group increased by 60%, but there was no significant difference between the two groups. HOMA IR decreased after treatment in both groups compared with that before treatment, with a decrease of 15% in the Ruianning group and a drop of 16% in the Daymeng group, but there was no significant difference between the two groups. The decrease in HOMA IR after treatment was associated with a decrease in fasting and postprandial blood glucose. (3) The level of PI before treatment was (11.92 ± 2.27) pmol / L, the SI level was (55.32 ± 1.66) pmol / L, and the PI was 119.6%. After treatment, the fasting serum PI and SI levels were slightly decreased, but no statistically significant difference; the fasting serum PI and SI levels were up slightly, nor statistically significant; PI in the PI and There was no significant difference between the proportion of SI and that before treatment. Conclusion HOMA is used