2018 年第 1 期 第 13 卷

二甲双胍对初诊2型糖尿病患者纤溶酶原激活物抑制物1水平的影响

作者：董崇周谢莉萍 章结楼明慧黄海泉

英文作者：

单位：244000安徽省铜陵市人民医院内分泌科

英文单位：

关键词：糖尿病，2型；二甲双胍；纤溶酶原激活物抑制物1

英文关键词：

• 摘要：

• 【摘要】目的    观察二甲双胍对初诊2型糖尿病（T2DM）患者纤溶酶原激活物抑制物1（PAI-1）水平的影响。方法    选择2013年10月至2016年11月安徽省铜陵市人民医院的初诊T2DM患者95例，按照随机数字表法分为二甲双胍组（48例）和阿卡波糖组（47例）；选择同期体检中心健康体检者48例为对照组。二甲双胍组口服二甲双胍治疗12周；阿卡波糖组口服阿卡波糖治疗12周。测定受试者空腹血糖、餐后2 h血糖、糖化血红蛋白（HbA1c）和PAI-1水平，T2DM患者治疗后复查上述指标。结果    治疗前二甲双胍组和阿卡波糖组的空腹血糖、餐后2 h血糖、HbA1c和PAI-1水平均明显高于对照组（均P＜0.05），但2组间各指标差异无统计学意义（P＞0.05）。经治疗后，二甲双胍组空腹血糖、餐后2 h血糖、HbA1c及PAI-1水平均较治疗前明显下降［（6.5±0.7）mmol/L比（8.5±0.8）mmol/L、（9.9±1.2）mmol/L比（12.9±1.4）mmol/L、（6.2±0.5）%比（7.7±0.6）%、（38±8）μg/L比（50±9）μg/L］（P＜0.01）；阿卡波糖组空腹血糖、餐后2 h血糖及HbA1c水平较治疗前明显下降［（6.6±0.8）mmol/L比（8.3±0.9）mmol/L、（9.8±1.3）mmol/L比（13.1±1.6）mmol/L、（6.2±0.5）%比（7.6±0.5）%］（P＜0.01），PAI-1水平变化差异无统计学意义［（47±8）μg/L比（48±8）μg/L］（P＞0.05）。治疗后二甲双胍组PAI-1水平明显低于阿卡波糖组，差异有统计学意义（P＜0.01）。结论    二甲双胍治疗初诊T2DM患者可降低患者体内的PAI-1水平，该作用独立于其降血糖作用。

• Effect of metformin on plasminogen activator inhibitor-1 in newly diagnosed type 2 diabetic patients

  Dong Chongzhou, Xie Liping, Zhang Jielou, Ming Hui, Huang Haiquan

  Department of Endocrinology, Tongling People′s Hospital, Anhui Province, Tongling 244000, China

  Corresponding author: Huang Haiquan, Email: bydczll@126.com

  【Abstract】Objective     To investigate the effect of metformin on plasminogen activator inhibitor-1（PAI-1） in patients with newly diagnosed type 2 diabetes mellitus（T2DM）. Methods    A total of 95 patients with newly diagnosed T2DM admitted in Tongling People′s Hospital in Anhui Province from October 2013 to November 2016 were randomly divided into metformin group（48 cases） and acarbose group（47 cases）; 48 healthy people were enrolled from medical examination center as control group. Fasting plasma glucose（FPG）, postprandial 2 h plasma glucose（2 h PG）, glycosylated hemoglobin（HbA1c） and PAI-1 were tested before and after 12 weeks of metformin or acarbose treatment. Results    Baseline levels of FPG, 2 h PG, HbA1c and PAI-1 in diabetic patients were significantly higher than those in control group（P＜0.05）; there were no significant differences of the indexes between metformin group and acarbose group（P＞0.05）. After treatment, levels of FPG, 2 h PG, HbA1c and PAI-1 in metformin group significantly decreased compared to those before treatment［（6.5±0.7）mmol/L vs （8.5±0.8）mmol/L, （9.9±1.2）mmol/L vs （12.9±1.4）mmol/L, （6.2±0.5）% vs （7.7±0.6）%, （38±8）μg/L vs （50±9）μg/L］（P＜0.01）; levels of FPG, 2 h PG and HbA1c in acarbose group significantly decreased compared to those before treatment［（6.6±0.8）mmol/L vs （8.3±0.9）mmol/L, （9.8±1.3）mmol/L vs （13.1±1.6）mmol/L, （6.2±0.5）% vs （7.6±0.5）%］（P＜0.01）; the level of PAI-1 in acarbose group showed no significant difference compared to that before treatment［（47±8）μg/L vs （48±8）μg/L］（P＞0.05）. The level of PAI-1 in metformin group after treatment was significantly lower than that in acarbose group（P＜0.01）. Conclusion    Metformin treating newly diagnosed T2DM can effectively reduce PAI-1 level, which is independent of its hypoglycemic effect.

  【Key words】Diabetes mellitus, type 2;Metformin;Plasminogen activator inhibitor-1

  【Fund program】Scientific Research Project of Health and Family Planning Commission of Tongling, Anhui Province（［2012］06）