中国现代医学杂志
中國現代醫學雜誌
중국현대의학잡지
CHINA JOURNAL OF MODERN MEDICINE
2004年
17期
50-53
,共4页
吉非罗齐%代谢综合征%胰岛素抵抗%游离脂肪酸
吉非囉齊%代謝綜閤徵%胰島素牴抗%遊離脂肪痠
길비라제%대사종합정%이도소저항%유리지방산
Gemfibrozil%metabolic syndrome%insulin resistance%FFAs
目的观察吉非罗齐调脂效果及对代谢综合征患者胰岛素抵抗(IR)的影响;探讨血压或血脂变化与IR变化的关系.方法将60例代谢综合征(MS)患者按随机、对照、单盲方法分为尼群地平加吉非罗齐治疗组(n=40)和尼群地平加安慰剂对照组(n=20).两组服尼群地平将血压控制到正常;同时分别服用吉非罗齐胶囊0.6 g,2次/d,或安慰剂2粒,2次/d,共12周.服药前后分别测定BMI,WHR,SBP,DBP,FBS,FINS,FFAs,TG,TC,LDL-C和HDL-C.研究各指标变化与IR变化的相关性.运用多因素逐步回归分析筛选对改善IR有显著贡献的变量.结果①12周后,在吉非罗齐治疗组中,与治疗前比较,SBP,DBp,FBS,FINS,TG,TC和FFAs显著降低(P＜0.05),ISI显著增高(P＜0.05);FINS,TG,TC,HDL-C,LDL-C,FFAs和ISI的变化值与安慰剂对照组各指标变化值比较具有显著差异性(P＜0.05);②吉非罗齐治疗组ISI上升值与FFAs的下降值呈显著正相关(P＜0.05,r=0.353,Y=166.804X+30.769);亦与TG的下降值显著正相关(P＜0.05,r=0.329,Y=0.776X+0.67).多因素逐步回归分析发现仅TG的降低对ISI的上升有显著贡献.结论尼群地平控制MS患者血压后并不能改善其IR状态;常规剂量的吉非罗齐可以有效地降低血TG,TC,LDL-C,FFAs,升高HDL-C,并可能通过降低TG及FFAs改善了MS患者的IR.
目的觀察吉非囉齊調脂效果及對代謝綜閤徵患者胰島素牴抗(IR)的影響;探討血壓或血脂變化與IR變化的關繫.方法將60例代謝綜閤徵(MS)患者按隨機、對照、單盲方法分為尼群地平加吉非囉齊治療組(n=40)和尼群地平加安慰劑對照組(n=20).兩組服尼群地平將血壓控製到正常;同時分彆服用吉非囉齊膠囊0.6 g,2次/d,或安慰劑2粒,2次/d,共12週.服藥前後分彆測定BMI,WHR,SBP,DBP,FBS,FINS,FFAs,TG,TC,LDL-C和HDL-C.研究各指標變化與IR變化的相關性.運用多因素逐步迴歸分析篩選對改善IR有顯著貢獻的變量.結果①12週後,在吉非囉齊治療組中,與治療前比較,SBP,DBp,FBS,FINS,TG,TC和FFAs顯著降低(P＜0.05),ISI顯著增高(P＜0.05);FINS,TG,TC,HDL-C,LDL-C,FFAs和ISI的變化值與安慰劑對照組各指標變化值比較具有顯著差異性(P＜0.05);②吉非囉齊治療組ISI上升值與FFAs的下降值呈顯著正相關(P＜0.05,r=0.353,Y=166.804X+30.769);亦與TG的下降值顯著正相關(P＜0.05,r=0.329,Y=0.776X+0.67).多因素逐步迴歸分析髮現僅TG的降低對ISI的上升有顯著貢獻.結論尼群地平控製MS患者血壓後併不能改善其IR狀態;常規劑量的吉非囉齊可以有效地降低血TG,TC,LDL-C,FFAs,升高HDL-C,併可能通過降低TG及FFAs改善瞭MS患者的IR.
목적관찰길비라제조지효과급대대사종합정환자이도소저항(IR)적영향;탐토혈압혹혈지변화여IR변화적관계.방법장60례대사종합정(MS)환자안수궤、대조、단맹방법분위니군지평가길비라제치료조(n=40)화니군지평가안위제대조조(n=20).량조복니군지평장혈압공제도정상;동시분별복용길비라제효낭0.6 g,2차/d,혹안위제2립,2차/d,공12주.복약전후분별측정BMI,WHR,SBP,DBP,FBS,FINS,FFAs,TG,TC,LDL-C화HDL-C.연구각지표변화여IR변화적상관성.운용다인소축보회귀분석사선대개선IR유현저공헌적변량.결과①12주후,재길비라제치료조중,여치료전비교,SBP,DBp,FBS,FINS,TG,TC화FFAs현저강저(P＜0.05),ISI현저증고(P＜0.05);FINS,TG,TC,HDL-C,LDL-C,FFAs화ISI적변화치여안위제대조조각지표변화치비교구유현저차이성(P＜0.05);②길비라제치료조ISI상승치여FFAs적하강치정현저정상관(P＜0.05,r=0.353,Y=166.804X+30.769);역여TG적하강치현저정상관(P＜0.05,r=0.329,Y=0.776X+0.67).다인소축보회귀분석발현부TG적강저대ISI적상승유현저공헌.결론니군지평공제MS환자혈압후병불능개선기IR상태;상규제량적길비라제가이유효지강저혈TG,TC,LDL-C,FFAs,승고HDL-C,병가능통과강저TG급FFAs개선료MS환자적IR.
Objective: To study the effect of routine Gemfibrozil therapy on lipids disorders and insulin resistance in patients with MS and investigate the association between alterative free fatty acids (FFAs) and insulin resistance (IR). Methods: In the randomized, placebo-controlled and single blind study, 60 patients with MS were divided into two groups. 40 of them were treated for 12 weeks with 600 mg oral Gemfibrozil twice a day , 20 of them were treated for 12 weeks with 2 pills of placebo twice a day. Higher blood pressures in two groups were reduced to normal by oral Nitrendipine. Physical and biochemistric parameters were measured in the beginning and end of the therapy. Analysis of the association of each alterative parameter and IR was done. Factors contributed to improving IR were picked up with multivariate regression FBS, FINS, TG, TC, FFAs) significantly decreased, while ISI significantly increased;there were marked difference between alterations of some parameters(FINS, TG, TC, HDL-C, LDL-C, FFAs, ISI ) in the group there was a marked positive correlation between reduced value of FFAs or TGs and elevated value of ISI;reduced value of TGs treated by Gemfibrozil was the only factor contributed to improvement of ISI with multiby routine Gemfibrozil therapy. Maybe the improvement of IR is due to reduction of TG and FFAs.
