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目的:对比观察二甲双胍及吡格列酮对使用磺脲类药物治疗的2型糖尿病患者内皮功能的影响。方法:选择格列美脲单药治疗6个月以上2型糖尿病患者68例,随机分成2组:二甲双胍治疗组(A组)34例,在使用格列美脲的基础上加用二甲双胍(500mg,tid);吡格列酮治疗组(B组)34例,在使用格列美脲的基础上加用吡格列酮(15mg,bid);测定2组患者治疗前后的糖化血红蛋白、血脂、超敏C-反应蛋白、稳态模型胰岛素抵抗指数(HOMA-IR),同时利用超声检测肱动脉血流介导的内皮依赖性血管舒张功能(FMD)。结果:2组患者治疗后糖化血红蛋白、HOMA-IR均明显下降(P<0.05),FMD及高密度脂蛋白胆固醇均明显升高(P<0.05)。但2组患者治疗前后FMD的改变无差异(P>0.05)。结论:二甲双胍及吡格列酮均可改善2型糖尿病患者内皮依赖性舒张功能,但二者的作用无差异。
OBJECTIVE: To compare the effects of metformin and pioglitazone on endothelial function in type 2 diabetic patients treated with sulfonylureas. Methods: Sixty-eight patients with type 2 diabetes mellitus who were treated with glimepiride for 6 months or more were randomly divided into 2 groups: metformin-treated group (group A), 34 cases were treated with glimepiride plus metformin , tid); pioglitazone treatment group (group B) 34 cases, the use of glimepiride plus pioglitazone (15mg, bid); 2 groups of patients before and after treatment of glycated hemoglobin, blood lipids, high sensitivity C-reactive protein , Homeostasis model insulin resistance index (HOMA-IR), and brachial artery blood flow-mediated endothelium-dependent vasodilation (FMD). Results: After treatment, HbA1c and HOMA-IR of both groups were significantly decreased (P <0.05), FMD and HDL were significantly increased (P <0.05). However, there was no difference in FMD between the two groups before and after treatment (P> 0.05). CONCLUSION: Both metformin and pioglitazone can improve endothelium-dependent diastolic function in type 2 diabetic patients, but there is no difference between them.