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目的 在 2型糖尿病的治疗中 ,评价格列齐特 (商品名达美康 )是否能有效地防止微血管病变的进展。方法 7个中心为期 3年的随机对照前瞻性研究。 2 85例 2型糖尿病分成格列齐特和格列本脲两个治疗组 ,调整降糖药用量、定期监测空腹及餐后 2小时血糖以及糖基化血红蛋白至控制目标。每年检查眼底及尿微量白蛋白排量。结果 初访时两组患者的平均年龄、性别、糖尿病病程、血糖控制水平、血压、视网膜病变程度及尿微量白蛋白排量差异均无显著性 ,3年治疗中 ,两组的血糖控制及血压水平亦无差异。 3年末格列齐特治疗组视网膜病变进展 1期有 4例 (2 .5 8% ) ,格列本脲治疗组有 2 4例 (18.46 % ) ,差异具有显著性 (P <0 .0 0 0 1)。多因素Logistic逐步回归分析显示格列齐特治疗与视网膜病变进展 1期呈独立负相关关系 (P =0 .0 0 0 1)。利用相同的分析模式 ,3年末格列齐特治疗与尿微量白蛋白排量增加≥ 2 0 μg/min状态也呈独立负相关关系 (P =0 .0 0 96 )。 结论 在本研究人群 ,格列齐特治疗 3年防止视网膜病变进展 1期和尿微量白蛋白轻度进展的作用稍优于格列本脲
Objective To evaluate whether glycyrrhizin (brand name 达 美 康) can effectively prevent the progression of microangiopathy in the treatment of type 2 diabetes mellitus. Methods Seven centers were randomized, prospective, 3-year, prospective study. 2 85 cases of type 2 diabetes were divided into two treatment groups, gliclazide and glyburide, adjusting the dosage of hypoglycemic agents, regular monitoring of fasting and postprandial blood glucose 2 hours and glycosylated hemoglobin to control the target. Check the fundus and urinary albumin excretion every year. Results At the first visit, the average age, sex, duration of diabetes, blood glucose control, blood pressure, retinopathy and urine microalbumin clearance were not significantly different between the two groups. In the three years of treatment, the blood glucose control and blood pressure There is no difference in level. At the end of the third year, there were 4 cases (2.58%) in the progression of retinopathy in the gliclazide treatment group, 24 cases (18.46%) in the glyburide treatment group, the difference was significant (P <0. 0 0 0 1). Logistic regression analysis showed that there was a negative correlation between the treatment with gliclazide and progression of retinopathy stage 1 (P = 0.0101). Using the same analysis, there was also an independent negative correlation between the treatment with gliclazide at 3 years and ≥ 200 μg / min urinary albumin excretion (P = 0.096). Conclusions In this study population, Gliclazide treatment 3 years to prevent progression of retinopathy stage 1 and mild effects of urinary microalbumin slightly better than glibenclamide