Camerini-Davalos R A, Velasco C, Glasser M, Bloodworth J M
N Engl J Med. 1983 Dec 22;309(25):1551-6. doi: 10.1056/NEJM198312223092505.
We performed three oral glucose-tolerance tests and three muscle biopsies over a period of approximately three years in 41 asymptomatic patients with chemical diabetes. At base line, 13 (32 per cent) had an increased capillary basement-membrane width in muscle. Twenty-three patients received glipizide, a new oral hypoglycemic compound, and 18 received placebo. In the patients receiving placebo the mean width of the muscle capillary basement membrane increased from 135.9 +/- 9.0 nm (S.E.M.) to 169.3 +/- 9.5 nm (P = 0.01), but in those receiving glipizide the value decreased to a level no different from that in subjects without diabetes: from 152.9 +/- 2.9 to 127.5 +/- 5.1 nm (P = 0.01). These findings suggest that microangiopathy, as indicated by an increased capillary basement-membrane width in muscle, may be present in a considerable number of patients with asymptomatic diabetes and that the changes can be reversed by early drug treatment.
我们在大约三年的时间里，对41例无症状化学性糖尿病患者进行了三次口服葡萄糖耐量试验和三次肌肉活检。基线时，13例（32%）患者肌肉中的毛细血管基底膜宽度增加。23例患者接受了新型口服降糖化合物格列吡嗪治疗，18例接受了安慰剂治疗。接受安慰剂治疗的患者中，肌肉毛细血管基底膜的平均宽度从135.9±9.0纳米（标准误）增加到169.3±9.5纳米（P = 0.01），而接受格列吡嗪治疗的患者该数值降至与无糖尿病受试者无异的水平：从152.9±2.9纳米降至127.5±5.1纳米（P = 0.01）。这些发现表明，肌肉中毛细血管基底膜宽度增加所显示的微血管病变，可能在相当数量的无症状糖尿病患者中存在，且这些变化可通过早期药物治疗得到逆转。
