摘要
目的探讨应用短期持续皮下胰岛素输注(CSII)对初诊2型糖尿病(T2DM)患者胰岛B细胞功能,以及血清甘油三酯(TG)、C反应蛋白(CRP)、血清胰岛素样生长因子-1(IGF-1)的影响。方法选取2011年6月至2012年12月我院内分泌科收治的32例初诊T2DM患者,空腹血糖均〉11.1mmol/L,进行2周的胰岛素强化治疗。分析比较其治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹胰岛素(FINS)、餐后2h胰岛素(PINS)、空腹C肽(FC-P)、餐后2hC肽(PC-P)、糖化血红蛋白(HbAlc)、HOMA.p和HOMA-IR,以及血清甘油三酯(TG)、C反应蛋白(CRP)、胰岛素样生长因子-1(IGF-1)的变化。结果(1)治疗前、后胰岛B细胞功能相关指标比较:经胰岛素强化治疗2周后,FPG、2hPG、HbAlc、PINS、PC.P与治疗前相比有明显改善(t值分别为12.04、11.57、7.61、20.77、6.16,P均〈0.05),HOMA-β由治疗前(23.0±16.2)升至(71.0±23.8)(t=9.46,P〈0.05),HOMA—IR明显下降,由治疗前(6.8±2.1)降至(3.9±2.6)(t=4.81,P〈0.05);(2)治疗前、后IGF.1、TG、CRP的变化:治疗后IGF-1明显升高[(341±16)μg/L升至(471±17)μg/L],TG[(1.50±0.32)mmol/L降至(1.29±0.31)mmol/L]、CRP[(3.14±1.14)mg/L降至(1.95±0.52)mg/L](t值分别为8.65、26.73、23.62,P均〈0.05)。结论对伴明显高血糖的初诊T2DM患者,短期CSII强化治疗具有快速稳定控制血糖、改善脂代谢、抗炎和显著改善胰岛B细胞功能的作用。
Objective To investigate the effect on short-term continuous subcutaneous insulin infusion (CSII) treatment on beta-cell function, serum triglyceride (TG), C-reactive protein (CRP) and serum insulin like growth factor-1 ( IGF-1 ) of newly diagnosed type 2 diabetes mellitus(T2DM) patients. Methods Thirty-two newly diagnosed T2DM patients with fasting plasma glucose(FPG) 〉 11.1 mmol/L were treated with CSII for 2 weeks~ FPG,2 h postprandial blood glucose (2hPG), fasting insulin (FINS), 2 h postprandial insulin (PINS), fasting C peptide ( FC-P), 2 h postprandial C peptide (PC-P), glycosylated hemoglobin ( HbA1 c ), Homa-13, Homa-R,TG, CRP and IGF-1 were measured and compared before and after CSII. Results ( 1 ) Compared with that of before treatment, the levels of FPG,2hPG, HbAlc, PINS and PC-P in patients after treatment were dramatically improved( t = 12. 04, 11.57,7. 61,20. 77,6. 16 ; P 〈 0.05 ), and Homa-β increased from ( 23.0 ± 16. 2) to (71.0 ±23.8) (t =9.46,P 〈 0.05 ) ,while Homa-IR significantly decreased from (6. 8±2. 1 ) to ( 3.9 ±2. 6) ( t = 4. 81, P 〈 0.05 ). (2) The levels of TG and CRP significantly decreased from ( 1.50±0. 32 ) mmol/L,(3.14±1.14) to (1.29±0.31) mmol/L, (1. 95±0.52) mg/L(t=26.73,23.62;P〈O. O5).The levels of IGF-1 significantly increased from (341 ± 16) μg/L to (471 ± 17 ) μg/L ( t = 8.65, P 〈 O. 05 ). Conclusion The excellent glycemic control, improvement of lipid metabolism, anti-inflammatory and improvement of beta-cell function can be achieved with short-term CSII intensive therapy in newly diagnosed T2DM patients with severe hyperglycemia.
出处
《中国综合临床》
2014年第8期863-865,共3页
Clinical Medicine of China
关键词
2型糖尿病
持续皮下胰岛素输注
胰岛Β细胞功能
血脂
C反应蛋白
Type 2 diabetes mellitus
Continuous subcutaneous insulin infusion
Beta-cell function
Blood lipid
C-reactive protein