摘要
目的：观察初诊2型糖尿病患者血清基质金属蛋白酶-9（matrix metalloproteinase，MMP-9）水平和颈动脉内中膜厚度（carotid intima-media thickness，IMTc）的变化，以及罗格列酮治疗对两者的影响。方法：本实验采用前瞻性开放性病例对照研究，选择58例初诊2型糖尿病患者和25例正常人对照。初诊2型糖尿病分为两组：A组（31例）采用罗格列酮（4mg／d）＋二甲双胍联合治疗；B组（27例）单用二甲双胍（500～1500mg／d）治疗。高分辨超声检测IMTc，采用ELISA法检测血清MMP-9水平，3个月治疗后复测IMTc和MMP-9。并分析两者间的关系。结果：初诊2型糖尿病组IMTc和血清MMP-9水平显著升高（P〈0．05）。A组治疗前后IMTc和MMP-9差异有统计学意义（P〈0．05）。B组治疗前后IMTc和MMP-9无差异（P=0．071。P=0．065）。多元线性逐步回归分析显示，IMTc变化与MMP-9，HDL和WHR有关。结论：血清MMP-9水平与初诊2型糖尿病早期大血管病变关系密切，两者间有显著相关性。提示血清MMP-9水平与初诊2型糖尿病早期大血管病变关系密切。罗格列酮能显著降低初诊2型糖尿病患者中IMTc和血清MMP-9水平。这可能是罗格列酮血管保护的作用机制之一。
Objective To investigate the change of carotid intima-media thickness （ IMTc ） and serum matrix metalloproteinases-9 （MMP-9）levels in newly diagnosed Type 2 diabetic patients, and to analyze the relationship between MMP-9 and IMTc ; at the same time, to assess the effect of rosiglitazone on IMTc and MMP-9 levels. Methods Fifty-eight patients with Type 2 diabetes mellitus were selected in our study, and 25 healthy adults served as normal controls. Diabetic patients were divided into 2 groups： Group A （31 subjects ） were treated with rosiglitazone （4 mg/d ） , and Group B（ 27 subjects ） were treated with metformin alone （500 - 1 500 mg/d ）. They all received the treatment for 3 months. The IMTc was measured by high resolution uhrasonography, and the serum MMP-9 was determined by enzyme linked immunosorbent assay （ELISA） to assess the relationship between IMTc and MMP-9. Results The mean level of serum IMTc and MMP-9 in Type 2 diabetic patients was significantly higher than that in healthy adults （ P 〈 0.05 ）. After treatment with rosiglitazone and mefformin, IMTc and serum MMP-9 levels decreased significantly （ P 〈 0.05）. There was no obvious change in IMTc and serum MMP-9 levels in group B before and after the treatment （ P = 0. 071, P = 0. 065 ）. Using multiple linear stepwise regression analysis, the significant correlation between IMTc and HbA1 C, BMI, WHR, HDL-C, MMP-9 were discovered. Conclusion IMTc and MMP-9 levels increase in newly diagnosed Type 2 diabetic patients, suggesting that there is closely relationship between serume MMP-9 levels and early diabetic macrovascular disease. IMTc and MMP-9 can be reduced significantly in the newly diagnosed diabetic patients after being treated with rosiglitazone, which may be one of the protective mechanisms of vascular vessels.
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2006年第3期367-372,共6页
Journal of Central South University ：Medical Science
作者简介
黄卓（1979-），女，湖南长沙人，硕士研究生，主要从事糖尿病及其并发症的研究。
通讯作者，E-mail：lmx618@medmail．com
