目的 探討左卡尼汀輔助治療糖尿病的療效,為糖尿病的臨床治療提供新的思路。方法 160例糖尿病患者隨機(jī)分為對(duì)照組和治療組,各80例,對(duì)照組給予常規(guī)治療,治療組在此基礎(chǔ)上增加左卡尼汀口服溶液10 mL/次,2次/ d,連續(xù)治療4周為1療程,2個(gè)療程后比較各組治療前后血糖、血脂、卡尼汀群、糖化血紅蛋白(HbA1c)和胰島β細(xì)胞功能的變化。結(jié)果 治療后,兩組的空腹血糖(FPG)、總膽固醇(TC)、高密度脂蛋白(HDL)指標(biāo)較治療前均顯著下降(P < 0.05);治療組的三酰甘油(TG)、TC、HDL和低密度脂蛋白(LDL)指標(biāo)與對(duì)照組比較顯著改善,且差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。兩組的乙酰卡尼汀(ALC)水平較治療前均顯著改善且差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05);治療組的左卡尼汀較治療前明顯提高(P < 0.05),與對(duì)照組治療后比較也顯著提高,且差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。兩組的胰島素分泌指數(shù)(HOMA-B)、胰島素抵抗指數(shù)(HOMA-IR)、空腹胰島素(FINS)、1hINs/FINS、HbA1c與治療前相比差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05);其中HOMA-B、HOMA-IR、HbA1c與對(duì)照組比較顯著改善(P < 0.05);治療組的FINS低于對(duì)照組,但差異并無統(tǒng)計(jì)學(xué)意義。胰島素敏感指數(shù)(ISI)治療前后及兩組間差異均無統(tǒng)計(jì)學(xué)意義。結(jié)論 糖尿病患者體內(nèi)存在左卡尼汀水平的降低,外源性補(bǔ)充左卡尼汀能夠在一定程度上糾正糖尿病患者的能量代謝紊亂,對(duì)糾正其胰島素抵抗也具有良好效果。

Objective To investigate the efficacy of levocarnitine in the auxiliary treatment of diabetes, in order to provide new ideas for clinical treatment of diabetes. Methods Diabetic patients (160 cases) were randomly divided into control and treatment groups, and each group had 80 cases. The patients in control group were treated with conventional therapy. The patients in the treatment group were given Levocarnitine Oral Solution on the basis of control group, 10 mL/time, twice daily. For treatment of 4 weeks as a course. One course of treatment was 4 weeks. After two courses, blood sugar, blood lipid, carnitine group, hemoglobin A1c (HbA1c) and β-cell function of insulin between two groups before and after treatment were compared. Results After treatment, fasting plasma glucose (FPG), total cholesterol (TC), high-density lipoprotein (HDL) levels of two groups were lower than those of before treatment significantly (P < 0.05). Triglyceride (TG), TC, HDL, and low density lipoprotein (LDL) were improved significantly compared with those of control group, and the difference was significant (P < 0.05). Acetyl-L-carnitine (AC) levels of two groups were improved compared with those of before treatment with significant difference (P < 0.05). Levocarnitine of treatment group was improved more than that of before treatment (P < 0.05), and was improved more than that of control group, and the difference was significant (P < 0.05). Homeostasis model assessment-B (HOMA-B), insulin resistance index (HOMA-IR), fasting insulin (FINS), 1hINs/FINS, and HbA1c of two groups had statistically significant difference compared with those of before treatment (P < 0.05). In which, HOMA-B, HOMA-IR, HbA1c were improved significantly compared with those of control group (P < 0.05). FINS of treatment group was lower than that of control group, but there was no significant difference. Insulin sensitive index (ISI) had no significant difference between before and after treatment, and two groups. Conclusion Levocarnitine levels are decreased in patients with diabetes. The supplement of exogenous LC can correct the disorder of lipid metabolism in diabetic patients, but also has good effect in correcting the insulin resistance.