糖调节受损人群不同干预方法的临床效果观察

目的探讨糖调节受损（Impairedglucoseregulation，IGR）人群不同干预方法的临床效果。方法将204例1GR患者分为三组，生活方式干预组给予饮食控制＋运动疗法，吡格列酮组和二甲双胍组在生活方式干预基础上分别每日加用吡格列酮片38mg和二甲双胍缓释片38mg。分别检测i组干预前及干预两年结束时体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、甘油三脂（TG）、总胆固醇（TC）、空腹血糖（FPG）、餐后二小时血糖（2hPG）、空腹胰岛素（FINS）、餐后二小时胰岛素（2hlNS）水平。结果干预后三组IGR发生率比较差异无统计学意义（P〉0．05）；NGT发生率二甲双胍组与吡格列酮组显著高于干预组，差异有统计学意义（P〈0．05）；DM发生率二甲双胍组与吡格列酮组均显著低于干预组，差异有统计学意义（P〈0．05）。干预后三组在BMI、2hPG、FINS和2HINS与十预前比较，差异有统计学意义（P〈0．05），二甲双胍组与吡格列酮组2hPG、FINS和2HINS均显著低于干预组，差异有统计学意义（P〈0．05）。结论糖调节受损人群在生活方式干预的基础上使用吡格列酮或二甲双胍强化治疗比单纯生活方式干预能更有效地降低糖尿病的发生率。

The effects of different interventions on impaired glucose regulation

Objective To evaluate the clinical effects of different interventions on impaired glucose regulation. Method 204 cases of IGR were selected as subjects of study and divided into 3 groups ： lifestyle intervention group were given diet control and exercise therapy; Pioglitazone enhanced group and Metformin enhanced group were respectively given pioglitazone tablets of 30mg, metformin hydrochloride sustained-release tablets of 30mg daily,in addition to lifestyle intervention. Before intervention and two years after the intervention, the three groups were respectively detected for body mass index （BMI） , systolic blood pressure （SBP） , diastolic blood pressure （DBP） , glycerin three greases （TG） , total cholesterol（ TC ） , fasting blood glucose（FPG） , two-hour postprandial blood glucose （2hPG） , fasting insulin （FINS） , and two-hour postprandial insulin（2hlNS） levels. Findings No difference was recognized among the three groups in the incidence of IGR after intervention（ P 〈 0.05 ） , and the incidence of NGT of the Metformin group was higher than that of the intervention group.（ P 〈 0.05）. However, there was no difference between other groups（ P 〈 0.05 ） , incidence of DM of the Pioglitazone group and the Metformin group was lower than that of the intervention group （P 〈 0.05 ）. After intervention, the BMI, 2hPG, FINS and 2HINS of the three groups were lower than before（P 〈 0.05）. 2hPG, FINS and 2HINS of the Pioglitazone group and the Metformin group were lower than those of the intervention group（P 〈 0.05 ）. Conclusion The cases of diabetes mellitus in patients suffering impaired glucose regulation can be reduced by employing Pioglitazone or Metformin enhanced therapy in addition to lifestyle intervention.