肠内营养混悬液(TPF-DM)对2型糖尿病患者血糖、胰岛素和血脂的影响  

The effect of enteral nutritional suspension (diabetes) (TPF-DM) on blood glucose,serum insulin and lipids in patients with type 2 diabetes

作　　者：李玉秀[1] 潘诗海[2] 曾静波[1] 于康[3] 孙琦[1] 刘秋英[1] 秦薇[4] 张茜[1] 潘清蓉[1] 于建春[4] 徐涛[5] 韩少梅[5] 王姮[1] 

机构地区：[1]中国医学科学院 中国协和医科大学 北京协和医院内分泌科,100730 [2]第二军医大学附属长海医院营养科 [3]中国医学科学院 中国协和医科大学 北京协和医院营养科,100730 [4]中国医学科学院 中国协和医科大学 北京协和医院保健科,100730 [5]基础医学院统计学教研室

出　　处：《中华内科杂志》2007年第3期193-196,共4页Chinese Journal of Internal Medicine

摘　　要：目的评估肠内营养混悬液(TPF-DM)(Diason 0.75 kcal/ml)(1 kcal=4.184 kJ)对2型糖尿病患者血糖、胰岛素和血脂的影响。方法随机、对照、平行研究,对照药物采用肠内营养混悬液(TPF)(能全力0.75 kcal/ml)。76例符合条件的2型糖尿病患者随机进入试验组和对照组,最后完成例数试验组36例,对照组35例。观察时间6 d,全部热量来自肠内营养液,入组前行标准餐,结束时行肠内营养液餐,服用前(0 h)和服用后0.5、1、2、3 h 取血测定血糖、胰岛素、血脂和安全性指标,并计算血糖、胰岛素和血脂曲线下面积(AUC)。结果两组服用肠内营养混悬液后血糖、胰岛素AUC 均明显低于服用标准餐者,服用肠内营养混悬液(TPF-DM)的试验组服营养液后与服标准餐后血糖、胰岛素 AUC 差值绝对值明显大于对照组[(-6.42±8.62)h·mmol·L^(-1)比(-1.87±5.30)h·mmol·L^(-1),P<0.01;(-36.94±49-77)h·mIU·L^(-1)比(-18.20±32.62)h·mIU·L^(-1),P<0.05)]。两种营养液均能显著降低胰岛素抵抗,但两者相比差异无统计学意义。与标准餐相比,服用两种肠内营养混悬液餐后 TG AUC 明显下降,但两组间差异无统计学意义;对 TC、LDL-C、HDL-C 没有明显影响。两组安全性指标分析差异无统计学意义。结论与肠内营养混悬液(TPF)相比,肠内营养混悬液(TPF-DM)对2型糖尿病患者血糖和血清胰岛素影响更小,两者对血清 TG 有改善作用,对血脂其他项目没有影响。肠内营养混悬液(TPF-DM)对2型糖尿病患者是安全的。Objective To investigate the effect of a new enteral nutrition suspension （diabetes） （TPF-DM） （Diason 0.75 keaL/ml） （1 keal =4. 184 kJ）on blood glucose, serum insulin and lipids as compared with a standard formula （ Nutrison MF 0. 75 keaL/ml） in patients with type 2 diabetes. Methods A randomized, controlled, paralleled and single center trial was carried out. A total of 76 patients with type 2 diabetes without using insulin and obvious complications were randomized into a study group and a control group. 36 patients in the study group and 35 in the control group completed the trial. The observation lasted 6 days. All calories came from enteral nutrition. At baseline all the patients had standard mixed meal （ bread 50 g, egg 50 g, milk 250 ml, total calorie 400 keal） test and at the end of the trial a enteral nutrient meal （ enteral nutrient 400 ml, total calorie 300 keal） test. Blood samples were taken before the meal and 30,60, 120 and 180 minutes after the meal to test plasma glucose, serum insulin, serum lipids and some safety parameters. The area under curve （AUC） for plasma glucose, serum insulin, serum lipids was calculated. Results Compared with the mixed meal test, the AUC of plasma glucose and serum insulin during both Diason 0. 75 kcal/ml test and standard formula （ Nutrison MF 0.75 kcal/ml） test were significantly lower （P 〈0.01 ）. The change at basehne in the study group was more than that in the control group [ the change of AUC for plasma glucose （ - 6.42 ± 8. 62） h · mmol · L^- 1 vs （ - 1.87 ± 5.30 ） h · mmol · L^- 1, P 〈 0.01;that of AUC for serum insulin （ -36.94 ±49.77） h · mlU · L^-1 vs （ -18.20 ±32.62） h · mIU · L^-1 ,P 〈 0.05 ]. Both the enteral nutrition formula can reduce insulin resistance （ caculated by HOMA-IR） ,but there was no difference between them. There was no significant effect on total cholesterol, high density lipoprotein and ]ow density lipoprotein. AUC of serum triglycerides was ]ower during the tes

关 键 词：糖尿病 非胰岛素依赖型 血糖 胰岛素 肠内营养混悬液 

分 类 号：R587.1[医药卫生—内分泌]