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目的 :探讨阿卡波糖对 2型糖尿病病人胰岛素抵抗的影响。方法 :16 0例 2型糖尿病病人随机分为 2组 ,治疗组 80例口服阿卡波糖治疗 ,前 2wk ,5 0mg ,po ,tid ,2wk后 ,10 0mg ,po ,tid ;安慰剂组 80例口服安慰剂 ,方法同治疗组 ,疗程为 2 4wk。同时观察空腹及餐后 2h血糖、血清胰岛素水平、体重指数、糖化血红蛋白、空腹时的红细胞胰岛素受体和红细胞膜流动性治疗前后变化。结果 :(1)wk 4时 ,阿卡波糖明显降低病人的空腹血糖、餐后 2h血糖、糖化血红蛋白 ,下降值分别为 :(2 .9±s 0 .8)mmol·L- 1,(4.0± 1.8)mmol·L- 1,(1.2± 2 .1) % ,P<0 .0 1;(2 ) 2 4wk后 ,阿卡波糖降低病人的体重、空腹血清胰岛素、餐后 2h血清胰岛素 ,下降值分别为 :(6± 4 )kg·m- 2 ,(10± 6 )MIU·L- 1,(14± 10 )MIU·L- 1,增加红细胞胰岛素受体 ,升高值为 :(80± 71)sites·RBC- 1,降低膜流动性 ,下降值为 :(1.5± 1.3) ,P <0 .0 1。结论 :阿卡波糖能改善 2型糖尿病病人的胰岛素抵抗
Objective: To investigate the effect of acarbose on insulin resistance in type 2 diabetic patients. Methods: One hundred and sixty patients with type 2 diabetes mellitus were randomly divided into two groups. The treatment group received oral acarbose 80 mg, po, tid and placebo 80 Example oral placebo, the same method with the treatment group, treatment for 2 4wk. At the same time, fasting and 2h postprandial blood glucose, serum insulin, body mass index, glycosylated hemoglobin, fasting red blood cell insulin receptor and erythrocyte membrane fluidity before and after treatment were observed. Results: (1) At week 4, acarbose significantly decreased fasting blood glucose (FBG). The postprandial blood glucose, hemoglobin and glycated hemoglobin at 2h were (2. 9 ± s 0 .8) mmol·L -1, 4.0 ± 1.8) mmol·L -1, (1.2 ± 2.1%), P <0.01; (2) After 24 weeks, acarbose decreased body weight, fasting serum insulin, postprandial serum (6 ± 4) kg · m-2, (10 ± 6) MIU · L-1 and (14 ± 10) MIU · L-1, respectively. The increase of insulin receptor was : (80 ± 71) sites · RBC-1 decreased the membrane fluidity, with a decrease of (1.5 ± 1.3) P <0.01. Conclusion: Acarbose can improve insulin resistance in type 2 diabetic patients