论文部分内容阅读
[目的]探讨二甲双胍联合吡格列酮对精神分裂症(SP)合并2型糖尿病(T2DM)患者体脂成分及α、β细胞功能的影响.[方法]选择2015年1月至2016年6月本院收治的SP合并T2DM患者180例,按照随机数表法分为对照组与观察组,每组90例.两组均予常规基础治疗,对照组采用二甲双胍治疗,观察组采用二甲双胍加用吡格列酮治疗,比较两组治疗效果、治疗前后糖代谢、体脂成分、α、β细胞功能的变化及不良反应发生率.[结果]①治疗后,两组空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)均降低(P<0.05),观察组2hPG降低幅度高于对照组(P<0.05).②治疗后,两组胰岛素抵抗指数(HOMA-IR)降低、胰岛素分泌指数(HOMA-β)上升(P<0.05),观察组HOMA-β高于对照组,HOMA-IR、胰高血糖素水平低于对照组(P<0.05).③治疗后,两组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均降低,三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)上升(P<0.05),观察组治疗后TC、LDL-C均低于对照组(P<0.05).④治疗后,观察组体质量、体脂率(BF)均低于对照组(P0.05).[结论]SP合并T2DM患者体脂率上升,胰岛α、β细胞功能降低,早期采用二甲双胍联合吡格列酮干预,可改善患者体脂成分,优化胰岛α、β细胞功能.“,”[Objective]To analyze the effect of early hypoglycemic agents(metformin and pioglitazone)on the chan-ges in body fat composition,α and β cell function in patients with schizophrenia(SP)and type 2 diabetes mellitus (T2DM).[Methods]A total of 180 patients with SP and T2DM treated in our hospital from January 2015 to June 2016 were selected in the study.Patients were divided into the control group and the observation group by random number table method,with 90 cases in each group.Both groups were given routine basic treatment.The control group was treated with metformin while the observation group was treated with metformin and pioglitazone.Changes in glucose metabolism, body fat composition,α and β cell function before and after treatment were determined and the therapeutic effects were compared between the two groups.The incidence of adverse reactions was statistically analyzed.[Results]After treat-ment,the fasting blood glucose(FPG),postprandial 2h blood glucose(2hPG)and glycosylated hemoglobin(HbA1c)in the two groups were decreased(P <0.05),but the decrease of 2hPG was more obvious in the observation group than in the control group(P <0.05).After the treatment,the insulin resistance index(HOMA-IR)was decreased and insulin secretion index HOMA-β was increased in both groups(P <0.05).HOMA-β was higher in the observation group than the control group,while HOMA-IR and glucagon levels were lower in the observation group than the control group(P<0.05).After treatment,the total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)were decreased, while triglyceride(TG)and high-density lipoprotein(HDL-C)were increased(P <0.05).The levels of TC and LDL-C in observation group after treatment were lower than those in the control group(P <0.05).After treatment,the body weight and body fat percentage(BF)in the observation group were lower than those in the control group(P 0.05).[Conclu-sion]The body fat percentage is high,function of islet α and β cells is decreased in patients with SP and T2DM.The early treatment with metformin and pioglitazone can improve the body fat composition and optimize the function of islet α and β cells.