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目的观察罗格列酮对2型糖尿病(T2DM)患者的长期疗效和安全性。方法采用自身治疗前后对照法,对单用或格列吡嗪加治疗,血糖控制欠佳的 T2DM 患者59例加用罗格列酮治疗,进行3年随访,对血糖下降至空腹<5.5mmoL/L 或餐后2h<6.5mmoL/L 的病人减少格列吡嗪剂量7.5mg/d,观察治疗前后血糖、糖化血红蛋白(HbA_1c)。空腹胰岛素(FINS),空腹 C-肽(FC-P),稳态模型胰岛素抵抗(HomaIR)指数,高敏 C 反应蛋白(hsC-RP)及格列吡嗪用量。结果加服罗格列酮后,FPG、2hPG、HbA_1c、FINS、FC-P、hsC-RP 均明显下降,HomaIR 明显改善(P<0.01),格列吡嗪用量明显减少,至实验结束时共有28例患者完全停用格列吡嗪而血糖控制良好。结论单用格列吡嗪或格列吡嗪加二甲双胍疗效欠佳的 T2DM 患者加服罗格列酮能长期有效控制血糖,减少或停用原联合应用的格列吡嗪。
Objective To observe the long-term efficacy and safety of rosiglitazone in type 2 diabetes mellitus (T2DM). Methods Fifty-nine patients with T2DM treated with glipizide alone or with glipizide alone were treated with rosiglitazone for three years. Blood glucose was decreased to 5.5 mmoL / L or postprandial 2h <6.5mmoL / L patients reduced glipizide dose 7.5mg / d, observed before and after treatment of blood glucose, glycosylated hemoglobin (HbA_1c). Fasting insulin (FINS), fasting C-peptide (FC-P), homeostasis model insulin resistance (HomaIR) index, high sensitivity C-reactive protein (hsC-RP) and glipizide dosage. Results After oral administration of rosiglitazone, the levels of FPG, 2hPG, HbA_1c, FINS, FC-P and hsC-RP were significantly decreased, HomaIR significantly improved (P <0.01) and the amount of glipizide significantly decreased. Twenty-eight patients discontinued glipizide completely and had good glycemic control. Conclusions Rosiglitazone alone can effectively control blood glucose and reduce or stop the use of glipizide in combination with glipizide or glipizide plus metformin in patients with T2DM.