胰岛素强化治疗对初发2型糖尿病患者胰岛β细胞功能的影响  

The Effects of Intensive Insulin Therapy on the β Cell of Islets of Pancreas in Incipient Type Diabetes Patients

作　　者：邢莉[1] 

机构地区：[1]山西长治医学院附属和平医院内分泌科,046000

出　　处：《医学研究杂志》2007年第8期46-50,共5页Journal of Medical Research

摘　　要：目的观察短期胰岛素强化治疗和使用口服降糖药对初发2型糖尿病胰岛β细胞功能的影响。方法对60例空腹血糖(FBG)≥11.0mmol/L,糖化血红蛋白(HbA1c)≥9.0%,体重指数(BMI)≤25kg/m2的初发2型糖尿病患者随机分为胰岛素强化治疗组(A组)和口服降糖药物治疗组(B组),比较血糖达标所需天数、低血糖发生频率,治疗前后FBG、餐后2h血糖、HbA1c、基础胰岛素分泌量(FINS)、C-肽释放试验、稳态模型β细胞功能指数(HOMA-B)、稳态模型β细胞的胰岛素抵抗指数(HOMA-IR)。结果A组和B组血糖达标天数分别为13.77±2.18天、18.77±4.32天(P<0.0001);有显著性差异。A组:治疗后基础胰岛素无显著性差异(P>0.05);HbA1C明显降低(P<0.0001);基础C-肽增加(P<0.05;1h、2hC-肽明显增加(P<0.0001);3hC-肽增加(P<0.05;HOMA-B明显增加(P<0.0001);HOMA-IR明显降低(P<0.0001),有显著性差异。B组:治疗后基础胰岛素无显著性差异(P>0.05);HbA1C明显降低(p<0.0001),有显著性差异;基础C-肽、1h、2h、3hC-肽无显著性差异(P>0.05);HOMA-B明显增加(p<0.0001);HOMA-IR明显降低(P<0.0001),有显著性差异。两组间各项指标比较:A组HbA1C与B组无显著性差异(P>0.05);基础胰岛素A组较B组有显著性差异(P<0.0001);两组治疗后C-肽经重复测量方差分析有统计学意义(F=15.949、P=0.000);HOMA-BA组较B组明显增加(P<0.0001),有显著性差异;HOMA-IRA组较B组无显著性差异(P>0.05)。结论胰岛素强化治疗初发2型糖尿病具有快速、稳定、理想的控制血糖作用,能在短期内通过解除糖毒性作用,较传统的口服降糖药物能在一定程度上恢复β细胞功能。Objective To investigate how the short - term intensive insulin treatment and oral hypoglycemic agents influence the function of insulin βcell of newly diagnosed type 2 diabetes patients. Methods Sixty newly diagnosed type 2 diabetes patients with FBG≥11. Ommol/1, HbA1c≥9.0% , BMI ≤ 25kg/m^2 , were randomly assigned to two groups, group A was given short - term intensive insulin treatment ,group B was given oral hypoglyeemie agents. The two groups were analyzed with the fate of attaining standard blood glucose level, the frequently of hypoglycemia, compared with the FBG after treatment with that before treatment, the blood glucose level in 2 hours after meal, the HbA1c,the FINS,the C - P trail, the HOMA - B and the HOMA - IR. Results The days of attaining standard blood glucose level in group A and group B showed a significant differences （ P 〈 0. 0001 ） o In group A, after treatment, the levels of FINS were eomparable（P 〉0.05）;the levels of HbAlc and HOMA -IR decreased obviously while the levels of HOMA -B and C -P in 1 and 2 hours after meal increased obviously,they showed significant differences（ P 〈 0. 0001 ）. The levels of the basal C - P and the C - P in 3 hours after meal increased, they showed significant differences（ P 〈 0.05）. In group B, the levels of FINS were comparable（ P 〉 0.05 ） ;the levels of HbA1c and the HOMA - IR decreased obviously, the levels of HOMA - B increased obviously, they showed significant differences （P 〈 0. 0001 ） ,The levels of C -P at 1 h ,2h ,3h were comparable（ P 〉 0.05）. Compared with the target between the two groups,, the levels of HbAlc were comparable between group A and group B（ P 〉 0.05） ; The levels of basal FINS showed a significant differences between group A and group B （P 〈 0. 0001 ）. After treatment, the levels of C - P were measured at 0,1 h,2h ,3 h They showed a significant difference （F = 15. 949,P =0. 000）;the level of HOMA- A showed a significant difference between group A and group B （P 〈 0

关 键 词：初发2型糖尿病 胰岛Β细胞功能 强化治疗 胰岛素 

分 类 号：R587.1[医药卫生—内分泌]