论文部分内容阅读
目的:研究不同剂量二甲双胍对糖耐量受损(IGT)患者血糖波动及下肢血管病变的影响。方法:采用随机、对照、前瞻性研究,将2013年4月~2014年6月120例IGT患者随机机化分为3组,A组患者给予二甲双胍,500 mg·次-1,1次·d-1,B组给予500 mg·次-1,2次·d-1,C组给予500 mg·次-1,3次·d-1,所有患者均给予等同的运动和饮食干预,30 d为1疗程,共3疗程,对比治疗前后胰岛素抵抗状态、血糖和体重,并随访2年,观察患者下肢血管病变情况。结果:治疗后,C组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(HbA1c)、血糖波动系数、最高血糖]、胰岛素指标[空腹胰岛素水平(FIns)、胰岛素抵抗指数]、血脂均是最低,其次是B组和A组,组间比较有统计学差异(P<0.05);C组胰岛β细胞功能(HOMA-β)最高,其次是B组和A组,组间比较有统计学差异(P<0.05);3组治疗期间发生不良反应率比较无统计学差异(P>0.05);随访2年期间C组未发生下肢血管病变,B组发生2例下肢血管病变,A组发生4例。结论:IGT患者早期采用高剂量的二甲双胍能够有效降低患者血糖波动和代谢指标,在预防下肢血管病变有明显的临床效果。
Objective: To investigate the effects of different doses of metformin on blood glucose and blood vessel disease in patients with impaired glucose tolerance (IGT). Methods: A randomized, controlled, prospective study of 120 patients with IGT between April 2013 and June 2014 was randomized into 3 groups. Patients in group A were given metformin 500 mg · d -1,1 d The patients in group B were given 500 mg · -1,2 d · d -1, while those in group C were given 500 mg · d -1,3 d · d -1. All patients were given the same exercise and diet intervention for 30 days For a course of treatment, a total of 3 courses, compared with insulin resistance before and after treatment, blood glucose and body weight, and followed up for 2 years to observe the lower extremity vascular disease. Results: After treatment, the levels of fasting blood glucose (FPG), 2 h PG and HbA1c, the coefficient of fluctuation of blood glucose, the highest blood glucose, and the insulin level [fasting insulin (FIns) , Insulin resistance index], blood lipids were the lowest, followed by group B and group A, the difference was statistically significant (P <0.05); C group islet beta cell function (HOMA-β) highest, followed by group B and There was no significant difference between the two groups (P> 0.05). There was no significant difference in adverse reaction rate between the three groups during the treatment (P> 0.05) 2 cases of lower extremity vascular lesions, A group of 4 cases. Conclusion: Early use of high-dose metformin in patients with IGT can effectively reduce blood glucose and metabolic parameters in patients with lower extremity vascular lesions have a significant clinical effect.