马来酸罗格列酮联合胰岛素治疗2型糖尿病的临床效果观察

目的：比较胰岛素联合马来酸罗格列酮治疗和单用胰岛素治疗2型糖尿病患者的疗效。方法：将61例应用胰岛素治疗而血糖控制不佳的2型糖尿病患者分成治疗组（胰岛素加马来酸罗格列酮4mg／d）与对照组（胰岛素治疗），随访观察12周。结果：两组患者治疗后血糖均得到良好控制。但治疗组胰岛素日需求量明显低于对照组（P〈0．01）；与对照组相比，治疗组血甘油三酯下降，而高密度脂蛋白胆固醇升高（P〈0．05），空腹及餐后2h血浆胰岛素水平减少（P〈0．05），B细胞功能指数升高（P〈0．05），胰岛素抵抗指数显著降低（P〈0．01）。结论：马来酸罗格列酮与胰岛素联用能使2型糖尿病患者血糖、血脂改善，增加胰岛素敏感性，降低胰岛素抵抗。减少心血管疾病发生的危险因素，优于单用胰岛素治疗。

Combination of insulin and rosiglitazone in the treatment of type 2 diabetes mellitus

Objective To compare the efficacy of insulin in combination with rosiglitazone with that of insulin alone in the treatment of type 2 diabetes mellitus. Methods Sixty-one type 2 diabetics poorly responsive to initial insulin therapy were assigned to the treatment group (insulin plus rosiglitazone 4 mg daily) and the control group, and were then followed up for 12 weeks. Results The glycemic control was improved in both groups after treatment, while the daily insulin usage was significantly lower in the treatment group than in the control group (P < 0.01); Compared with those in the control group, TG level declined and HDL-C increased (P < 0.05), fasting and 2h-postprandial plasma insulin levels reduced (P < 0.05), HOMA-IS elevated (P < 0.05) and HOMA-IR declined (P < 0.01). Conclusions Combination of insulin and rosiglitazone not only improves the levels of glucose and lipid, but also increases insulin sensitivity, relieves insulin resistance, and lowers the risk factors for cardiovascular disease. It is superior to insulin alone.