目的 探討二甲雙胍或吡格列酮對(duì)2型糖尿病患者的療效及其對(duì)超氧化物歧化酶（SOD）、丙二醛（MDA）的影響。方法 納入北京市昌平區(qū)中西醫(yī)結(jié)合醫(yī)院收治的2型糖尿病患者160例，按隨機(jī)數(shù)字表法平均分為二甲雙胍組和吡格列酮組，分別給予鹽酸二甲雙胍腸溶片（1 g/次，每日2次）和鹽酸吡格列酮片（30 mg/次，每日1次），兩組療程均為4周。比較兩組患者治療前后空腹血糖（FPG）、餐后2 h血糖（PPPG）、糖化血紅蛋白（HbA1c），血脂以及兩組患者SOD、MDA水平。結(jié)果 給予降糖藥4周后，兩組患者FPG、PPPG、HbA1c均顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，二甲雙胍組患者三酰甘油（TG）、低密度脂蛋白（LDL）水平顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05），而吡格列酮患者則無顯著性變化。吡格列酮組患者血清MDA水平下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；二甲雙胍組患者血清SOD水平顯著上升（P<0.05），且顯著高于吡格列酮組（P<0.05）；吡格列酮組患者血清MDA水平顯著下降（P<0.05），且顯著低于二甲雙胍組（P<0.05）。結(jié)論 二甲雙胍或吡格列酮均能改善胰島素抵抗和糖尿病并發(fā)癥；吡格列酮降低MDA水平效果優(yōu)于二甲雙胍，但增加SOD水平僅見于二甲雙胍。兩種藥物對(duì)氧化應(yīng)激的作用機(jī)制不同，有利于聯(lián)合用藥。

Objective To investigate the effect of Metformin or Pioglitazone on patients with type 2 diabetes and its effect on superoxide dismutase (SOD), malondialdehyde (MDA).Methods A total of 160 patients diagnosed as T2DM were randomly selected, they were randomly divided into Metformin group and Pioglitazone group he treatment course was 4 weeks. We compared fasting blood glucose (FPG), postprandial blood glucose (PPPG), glycosylated hemoglobin (HbA1c) and serum level of superoxide dismutase (SOD), malondialdehyde (MDA) before and after treatment between two groups.Results After giving the hypoglycemic drugs for 4 weeks, the levels of FPG, PPPG and HbA1c in the two groups were significantly decreased (P < 0.05). The SOD in the two groups were increased, and the MDA were decreased. The serum level of SOD in Metformingroup was significantly higher than in Pioglitazone group (P < 0.05). The serum MDA level in Pioglitazone group was significantly lower than in Metformingroup (P < 0.05).Conclusions Both Metforminand Pioglitazone can improve insulin resistance and diabetes complications. Pioglitazone was superior to Metforminto improve oxidative stress as reflected by reduction in MDA but the antioxidant effect i.e. increases in SOD was seen with Metforminonly. The differing mechanism of actions of the two drugs on oxidative stress favors co prescription.