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目的比较瑞格列奈、格列吡嗪速释片、格列吡嗪控释片、格列本脲4种胰岛素促泌剂对胰岛β细胞分泌胰岛素的影响。方法以静脉葡萄糖耐量试验(IVGTT)不同时相的胰岛素分泌曲线下面积(AUC)评价6名健康者和10例初发2型糖尿病患者胰岛β细胞分泌功能。每例受试者口服安慰剂、0.5mg瑞格列奈、5 mg格列吡嗪速释片、5 mg格列吡嗪控释片、2.5 mg格列本脲,以IVGTT时的胰岛素曲线下面积AUC0-19 min代表1相分泌量,AUC19-180 min代表2相分泌量,AUC0-180 min代表分泌总量。结果在两组受试者中,4种药物皆使胰岛素AUC0-180 min明显增加且大于安慰剂组(均P<0.05)。瑞格列奈使胰岛素AUC0-19 min明显增加并高于安慰剂组(P<0.05);格列吡嗪速释片及控释片也使胰岛素AUC0-19min增加,但两者增加比例均无统计学意义(均P>0.05),相反促进胰岛素AUC19-180 min作用更明显(均P<0.05)。而格列本脲对胰岛素AUC0-19 min作用甚微,对胰岛素AUC19-180min作用最大。结论瑞格列奈以促进胰岛素1相分泌为主,格列吡嗪对胰岛素1相和2相分泌皆有促进作用,且控释片和速释片间差异无统计学意义。格列本脲以促进2相分泌为主。
Objective To compare the effects of repaglinide, glipizide immediate-release tablets, glipizide controlled-release tablets and glibenclamide on pancreatic β-cell insulin secretion. Methods The area under the curve of insulin secretion (AUC) at different phases of intravenous glucose tolerance test (IVGTT) was used to evaluate the pancreatic β-cell secretory function in 6 healthy individuals and 10 patients with newly diagnosed type 2 diabetes. Each subject was given oral placebo, 0.5 mg repaglinide, 5 mg glipizide immediate release tablets, 5 mg glipizide controlled-release tablets, and 2.5 mg glibenclamide at IVGTT under the insulin curve Area AUC0-19 min on behalf of 1 phase secretion, AUC19-180 min on behalf of 2 phase secretion, AUC0-180 min on behalf of the total secretion. Results In both groups, all four drugs significantly increased insulin AUC0-180 min and were greater than placebo (all P <0.05). Repaglinide increased insulin AUC0-19 min significantly and was higher than placebo group (P <0.05). Glipizide immediate-release tablets and controlled-release tablets also increased insulin AUC0-19min, but neither (All P> 0.05). On the contrary, the effect of promoting insulin AUC19-180 min was more obvious (all P <0.05). Glibenclamide had little effect on insulin AUC0-19 min and had the greatest effect on insulin AUC19-180min. Conclusion Repaglinide is the predominant factor that promotes the secretion of 1-phase insulin. Glipizide can promote the secretion of 1-phase and 2-phase insulin, and there is no significant difference between controlled-release and immediate-release tablets. Glyburide to promote 2-phase secretion based.