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目的比较二甲双胍格列吡嗪复方制剂及单药二甲双胍或格列吡嗪控制T2DM患者血糖达标前后APN水平的变化。方法将63例T2DM患者分为3组:A组23例,口服二甲双胍格列吡嗪复合制剂;B组18例,口服二甲双胍片;C组22例,口服格列吡嗪片。各组疗程均为12周。比较治疗前后空腹及餐后血糖、血清胰岛素、HbA1c、胰岛素抵抗指数(HOMA-IR)、APN等相关指标。结果治疗前后,A、B组APN升高(P<0.01),C组APN水平下降,但组间比较差异无统计学意义;3组间APN水平值比较显示,A组高于B、C组(P<0.05或P<0.01),B组高于C组(P<0.01);相关性分析显示,APN水平值与HOMA-IR、BMI呈负相关(r=-0.342,P<0.01;r=-0.336,P<0.01)。结论二甲双胍可能通过改善IR、控制体重进而降低BMI等途径来升高APN;二甲双胍格列吡嗪复方制剂改善APN可能是二甲双胍和格列吡嗪的协同作用,能升高血清APN水平。
Objective To compare the changes of APN levels before and after metformin metformin and metformin or glipizide in patients with T2DM. Methods Sixty-three patients with T2DM were divided into three groups: group A (n = 23), oral metformin glipizide (n = 18); group B (n = 18) and metformin orally; Each course of treatment was 12 weeks. Fasting and postprandial blood glucose, serum insulin, HbA1c, insulin resistance index (HOMA-IR) and APN were compared before and after treatment. Results Before and after treatment, the APN in group A and group B were increased (P <0.01), while the level of APN in group C was decreased, but there was no significant difference between the two groups. The comparison of APN levels among the three groups showed that group A was higher than group B and C (P <0.05 or P <0.01), and in group B was higher than that in group C (P <0.01). Correlation analysis showed that the level of APN was negatively correlated with HOMA-IR and BMI (r = -0.342, = -0.336, P <0.01). Conclusion Metformin may increase APN by improving IR, controlling body weight and decreasing BMI. APS may be the synergistic effect of metformin and glipizide, and may increase serum APN level.