短期持续皮下胰岛素输注治疗初诊2型糖尿病的随访分析  

Follow-up analysis of short-term continuous subcutaneous insulin infusion therapy for newly diagnosed type 2 diabetes mellitus

作　　者：孙亚东[1] 马彦[1] 阚英[1] 邵红[1] 韩艳[1] 关红[1] 杨乐[1] 

机构地区：[1]吉林省人民医院内分泌科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2007年第3期591-594,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅资助课题(20050413-03)

摘　　要：目的:观察短期持续皮下胰岛素输注(CSII)对初诊2型糖尿病(T2DM)血糖控制的效果。方法:对179例初诊T2DM患者进行CSII治疗3周。以静脉葡萄糖耐量试验(IVGTT)对患者进行治疗前后自身对照,分析比较血糖(BG)、糖化血红蛋白(HbA1c)、胰岛素(INS)、C肽(C-P)的变化。停止治疗后0、3及8周分别重复监测上述指标。结果:纳入分析的159例患者应用CSII治疗前血糖控制均很差,平均空腹血糖(FPG)为(15.27±2.32)mmol.L-1,餐后血糖(PPG)为(22.18±3.43)mmol.L-1,HbA1c为14.95%±2.42%。CSII治疗3周结束时,FPG、PPG和HbA1c均较治疗前明显下降,分别为(5.52±1.30)mmol.L-1、(7.18±1.21)mmol.L-1和10.86%±1.33%(P<0.001或P<0.05)。患者不同程度地恢复了胰岛素(INS)分泌第一时相。在CSII治疗停止后3及8周,FPG、PPG和HbA1c较治疗前明显降低(P<0.001或P<0.05)。结论:初诊T2DM患者经CSII强化治疗3周有效者血糖得到良好控制。Objective To observe the effects of glycemic control in patients with newly diagnosed type 2 diabetes mellitus （T2DM） by continuous subcutaneous insulin infusion （CSII）. Methods A total of 179 patients with newly diagnosed T2DM received 3 weeks＇ treatment of CSII. Before-after study in the same patient was applied. Intravenous glucose tolerance test （IVGTT） was performed, and blood glucose, HbA1c, insulin, C-peptide （C-P） were measured before and after CSII. The same index was observed 3 and 8 weeks after drug withdrawal. Results Of all 179 patients, 159 cases were chosen. Before CSII, the average fasting plasma glucose （FPG） was （15.27±2.32） mmol· L^-1 , postprandial plasma glucose （PPG） was （22.18±3.43） mmol· L^-1 , and HbA1c was 14. 95% ± 2.42%. 3 weeks after CSII, FPG, PPG and HbA1c were significantly decreased E （5.52 ± 1.30） mmol· L^-1, （7. 18±1.21） mmol· L^-1 and 10.86%±1.33%, respectively] （P〈0. 001 or P〈0.05）. The patients had different degree restoration of the first-phase insulin secretion. 3 and 8 weeks after drug withdrawal, FPG, PPG and HbA1c were significantly reduced （P〈0. 001 or P〈0.05）. Conclusion The excellent glycemic control can be induced by 3 weeks; treatment of CSII in newly diagnosed T2DM.

关 键 词：糖尿病 非胰岛素依赖型 持续皮下胰岛素输注 葡糖耐量试验 

分 类 号：R587.1[医药卫生—内分泌]