糖适平治疗2型糖尿病的CGMS动态变化临床观察
作者：李昌祁，张建慧，冯佳庆，栾杰，马永文，李学庆，黄晓林，房庆华，刘舂英，段邻焕。
［摘要］ 目的 探讨糖适平治疗2型糖尿病的CGMS与多项目指标临床相关性。方法 近年诊断2型糖尿病患者22例，应用美国产动态血糖监测系统（CGMS Mini Med Inc)，测量药物治疗后不间断连续血糖监测曲线，与本药药代动力学水平做一动态分析。结果 口服糖适平2.5h时血糖水平曲线最低平，与其他时段血糖水平曲线差异有极显著性（P0.001)。其中每日6am口服本药，2.5h时血糖水平曲线为24h时最低平，与其他时段血糖水平曲线差异有极显著性（P0.001)。口服糖适平7.5h后血糖水平曲线渐次升高，直至再次口服本药后血糖水平曲线渐次降低直至口服糖适平2.5h时血糖水平曲线最低平。每日服药1次，24h血糖水平曲线较不服药者血糖水平曲线明显低平（P0.001)。结论 每日6am口服本药为最佳服药时间，口服本药2.5h时降糖作用最强；本药可在体内持续作用7.5～24h。
［关键词］ 2型糖尿病；糖适平；动态血糖监测 Clinical study of CGMS in type 2 diabetic patients treated with gliguidone。
［Abstract］ Objective To discuss relative indexes in type 2 diabetic patients treated with gliguidone and with continuous glucose monitoring system(CGMS).Methods The blood glucose by CGMS and the concentration of gliguidone in blood were measured in two patients with recently diagnosed type 2 diabete after they were administered with gliguidone.The relation between the blood glucose and the concentration of gliguidone in blood was analyzed.Results The curve of the blood glucose was lowest in 2.5 hours when gliguidone was taken.The blood glucose was significant statistics difference with the other blood glucose respectively(P0.001）.The curve of the blood glucose is lowest at 8∶30 am when gliguidone was administered at 6am and had statistic difference with the other blood glucose a day(P0.01).The blood glucose gradually rise in 7.5 hours after the administration,and declined to be lowest in 2.5 hours after the medicine was given. The blood glucose of patients who received the medicine once daily was lower than the others(P0.001).Conclusion The optimal time of the administration is 6am and the blood glucose is lowest in 2.5 hours after the medicine is given.The antidiabetic therapy blood concentration of the medicine sustains about 7.5 to 24 hours.
［Key words］ type 2 diabetes;gliguidone;continuous glucose monitoring system。
有关糖适平治疗2型糖尿病后的CGMS动态变化的临床观察与临床研究，迄今国内外报道较少。近年，我们将所诊断的56例2型糖尿病患者进行CGMS动态变化及水平参数临床观察与临床相关性研究，其中经糖适平治疗糖尿病患者有22例。现报告如下。
1 资料与方法。
1.1 一般资料 选择我院内分泌科病房、糖尿病专病门诊、糖尿病监测区近年新诊断的2型糖尿病患者56例，其中男29例，女27例，平均年龄（55.2±12.46）岁。
1.2 研究方法。
1.2.1 CGSM法 采用动态血糖监测系统（CGMS，Mini Med Inc）［1］对本组受试者进行连续的血糖监测。本组受试者又分为A组糖适平治疗组22例，B组非降糖药物治疗组34例（饮食+运动疗法）作为对照组。CGMS感应探头通过助针器置于腹部皮下，组织间液的葡萄糖氧化酶反应生成过氧化氢，过氧化氢氧化分解产生电信号，感应探头中的微电极将此电信号传输到监测记录器，数据经软件分析系统（CGMS software3.0）处理，而显示血糖水平的变化。CGMS每5min监测1次，记录组织间液的葡萄糖浓度，监测范围2.2～22.2mmol/L（40～400mg/dl）［1］。CGMS监测期间每天至少测定4次以上的指端血糖，以校正监测结果［2，3］。