Chan Norman Nor, Tong Peter C Y, So Wing-Yee, Leung Wilson Y S, Chiu Cherry K P, Chan Juliana C N
Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
Med Sci Monit. 2004 Mar;10(3):PI44-8. Epub 2004 Mar 1.
Few studies have examined the efficacy and safety of thiazolidinedione use in patients with diabetic nephropathy. Our goal was to examine the metabolic effects and tolerability of combination therapy with rosiglitazone and insulin in type 2 diabetic patients with nephropathy and renal failure.
MATERIAL/METHODS: We evaluated the metabolic effects and tolerability of rosiglitazone as an add-on therapy to insulin in 12 Chinese type 2 diabetic patients (5 males and 7 females) with nephropathy and renal impairment. The mean age of these patients was 65+/-8.3 years, and the mean duration of disease was 16.5+/-8.6 years. The initial daily dosage of rosiglitazone, 2 mg daily, was increased to 4 mg if their fasting plasma glucose concentrations were above 10 mmol/L after 4 weeks.
Over a mean period of 15.5 months, HbA1c improved significantly following the addition of rosiglitazone, from 8.57+/-1.42% to 7.48+/-1.3% (p=0.01). There was a trend towards improved lipid profile with this combination therapy, but it was not statistically significant. There was no major adverse events except for minimal weight gain (71.7+/-13.6 kg vs 73.9+/-13.1 kg, p=0.08).
Combination therapy with rosiglitazone and insulin has beneficial metabolic effects and is generally well tolerated in type 2 diabetic patients with nephropathy and mild to moderate renal failure.
很少有研究探讨噻唑烷二酮类药物在糖尿病肾病患者中的疗效和安全性。我们的目标是研究罗格列酮与胰岛素联合治疗对2型糖尿病肾病合并肾衰竭患者的代谢影响和耐受性。
材料/方法：我们评估了罗格列酮作为胰岛素附加治疗对12例中国2型糖尿病肾病合并肾功能损害患者（5例男性和7例女性）的代谢影响和耐受性。这些患者的平均年龄为65±8.3岁，平均病程为16.5±8.6年。罗格列酮的初始日剂量为每日2毫克，如果4周后空腹血糖浓度高于10毫摩尔/升，则增加至4毫克。
在平均15.5个月的时间里，加用罗格列酮后糖化血红蛋白显著改善，从8.57±1.42%降至7.48±1.3%（p = 0.01）。联合治疗有改善血脂谱的趋势，但无统计学意义。除体重略有增加外（71.7±13.6千克对73.9±13.1千克，p = 0.08），无重大不良事件。
罗格列酮与胰岛素联合治疗对2型糖尿病肾病合并轻至中度肾衰竭患者有有益的代谢作用，且耐受性良好。
