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目的:探讨吡格列酮对老年糖耐量低减患者(IGT)内皮功能的影响。方法:选取56例老年糖耐量正常者(NGT)及60例老年糖耐量低减患者(IGT),将IGT患者随机分两组进行治疗,每组30例,疗程为6月。非药物干预组,仅改变生活模式;综合治疗组,生活模式改变基础上服吡格列酮(每天30mg),观察内皮依赖舒张功能(EDD)变化。结果:EDD在IGT患者明显低于NGT个体;在非药物干预组和综合治疗组EDD治疗前无明显差别,6月后EDD在非药物干预组无明显改变,在综合治疗组明显升高(P<0.05),EDD变化值与糖化血红蛋白(HbA1C)变化值、胰岛素抵抗指数(HOMA-IR)变化值、高敏感C反应蛋白(HsCRP)变化值呈负相关。结论:在改变生活模式基础上,吡格列酮可进一步改善老年IGT患者内皮功能,其机制可能是通过降低血糖、改善胰岛素抵抗,抑制炎症反应等。
Objective: To investigate the effect of pioglitazone on endothelial function in elderly patients with impaired glucose tolerance (IGT). Methods: Fifty-six elderly patients with impaired glucose tolerance (NGT) and 60 elderly patients with impaired glucose tolerance (IGT) were enrolled. IGT patients were randomly divided into two groups, 30 patients in each group. The course of treatment was 6 months. Non-drug intervention group, only changing the life style; comprehensive treatment group, lifestyle changes based on the administration of pioglitazone (30mg daily), observed endothelium-dependent vasodilation (EDD) changes. Results: EDD in IGT patients was significantly lower than that of NGT individuals. There was no significant difference in non-drug intervention group and comprehensive treatment group before EDD treatment. EDD in non-drug intervention group did not change significantly after 6 months, and was significantly increased in comprehensive treatment group (P <0.05). The change of EDD was negatively correlated with the change of HbA1C, the change of HOMA-IR and the change of HsCRP. Conclusion: Based on the change of life style, pioglitazone can further improve endothelial function in elderly patients with IGT. Its mechanism may be through lowering blood sugar, improving insulin resistance and inhibiting inflammatory reaction.