CAJ | 학술논문

目的：观察初诊老年2型糖尿病患者血糖波动对氧化应激的影响，比较分析瑞格列奈与格列齐特对患者血糖波动及氧化应激的影响。方法将2013年1~12月60例初诊老年2型糖尿病患者分为瑞格列奈组和格列齐特组各30例。分别予以瑞格列奈和格列齐特治疗8周，采用动态血糖监测系统的日内平均血糖波动幅度（MAGE）以及日间血糖平均绝对差（MODD）评估血糖波动，同时测定谷胱甘肽过氧化物酶（GSH-Px）、超氧化物歧化酶（SOD）、丙二醛（MDA）以反映患者氧化应激水平。结果老年2型糖尿病患者血清GSH-Px、SOD水平与MAGE、MODD呈负相关（P<0.05），MDA水平与MAGE、MODD呈正相关（P<0.01）。瑞格列奈组和格列齐特组治疗后MAGE、MODD、MDA水平降低，血清GSH-Px、SOD水平增加，各指标与治疗前比较，差异均有统计学意义（P＜0.01）；但两组治疗后比较，差异无统计学意义（P＞0.05）。结论初诊老年2型糖尿病患者血糖波动与氧化应激水平存在显著相关性。瑞格列奈与格列齐特均可降低初诊老年2型糖尿病患者的血糖波动及氧化应激水平，2种药物疗效相似。
목적：관찰초진노년2형당뇨병환자혈당파동대양화응격적영향，비교분석서격렬내여격렬제특대환자혈당파동급양화응격적영향。방법장2013년1~12월60례초진노년2형당뇨병환자분위서격렬내조화격렬제특조각30례。분별여이서격렬내화격렬제특치료8주，채용동태혈당감측계통적일내평균혈당파동폭도（MAGE）이급일간혈당평균절대차（MODD）평고혈당파동，동시측정곡광감태과양화물매（GSH-Px）、초양화물기화매（SOD）、병이철（MDA）이반영환자양화응격수평。결과노년2형당뇨병환자혈청GSH-Px、SOD수평여MAGE、MODD정부상관（P<0.05），MDA수평여MAGE、MODD정정상관（P<0.01）。서격렬내조화격렬제특조치료후MAGE、MODD、MDA수평강저，혈청GSH-Px、SOD수평증가，각지표여치료전비교，차이균유통계학의의（P＜0.01）；단량조치료후비교，차이무통계학의의（P＞0.05）。결론초진노년2형당뇨병환자혈당파동여양화응격수평존재현저상관성。서격렬내여격렬제특균가강저초진노년2형당뇨병환자적혈당파동급양화응격수평，2충약물료효상사。
Objective To investigate the effect of glucose variability on oxidative stress in newly-diagnosed elderly pa-tients with type 2 diabetes mellitus(T2DM),and compare the influence of repaglinide and gliclazide on glucose variability and ox-idative stress. Methods A total of 60 elderly patients with newly-diagnosed T2DM from January to December of 2013 were divid-ed into repaglinide group and gliclazide group,30 cases in each group,which received repaglinide and gliclazide respectively for 8-week treatment. The glucose variability was evaluated by mean amplitude of glycemic excursions (MAGE) and mean of daily differences(MODD) of continuous glucose monitoring system(CGMS),meanwhile to detect the Glutathione Peroxidase(GSH-Px), Superoxide Dismutase(SOD) and Maleic Dialdehyde(MDA) to reflect the level of oxidative stress. Results The levels of GSH-Px and SOD in elderly patients with T2DM were negatively related with MAGE and MODD(P<0.05),while the MDA level was positively related with MAGE and MODD(P<0.01). The levels of MAGE,MODD and MDA in both groups decreased after treat-ment,and the levels of serum GSH-Px and SOD increased,the difference of above indicators in both groups before and after treat-ment had statistical significance(P<0.01),but the comparison between the two groups on the above indicators showed no statisti-cally significant difference(P>0.05). Conclusion The serum oxidative stress levels are significantly correlated with glucose variability in newly-diagnosed elderly patients with T2DM. Both repaglinide and gliclazide can reduce the amplitude of glucose variability and oxidative stress levels in newly-diagnosed elderly patients with T2DM with similar effect.