对家兔糖尿病模型胰岛素治疗的实验观察  

Experiment of insulin treatment on rabbit diabetes mellitus model

作　　者：李妮[1] 钟玫[1] 陈晖[1] 莫祥兰[1] 林华[1] 谭小燕[1] 周微雅[1] 陈翠玲[1] 黄莹[1] 

机构地区：[1]广西壮族自治区人民医院,南宁市530021

出　　处：《广西医学》2009年第3期313-316,共4页Guangxi Medical Journal

基　　金：广西科学基金(桂科基0385005)

摘　　要：目的以胰岛细胞的变化和凋亡程度为判断标准,探讨家兔糖尿病模型胰岛素用药治疗的适宜方案。方法利用四氧嘧啶制作家兔糖尿病模型,设计了多次胰岛素治疗组(A组)、50R预混胰岛素治疗组(B组)、30R预混胰岛素治疗组(C组)3种治疗方案,共治疗30 d,记录血糖达标时间及达标时Ins剂量,并与未治组、对照组比较血糖、胰岛素抗体及组织病理学变化;用苏木素-伊红染色(HE染色法)标记观察胰岛组织片及胰岛凋亡细胞。结果B组的达标胰岛素用量为(5.62±0.67)U/kg,较A、C组少,C组达标时胰岛素用量最多为(8.83±1.17)U/kg,差异有统计学意义(P<0 01)。A组血糖达标时间最短为(7.00±1.31)d、C组血糖达标时间最长为(19.63±1.41)d,各组间比较差异有统计学意义(P<0.001)。胰岛素抗体结合率C组最高,与A、B组比较差异有统计学意义(P<0.01)。C组胰岛损害最轻,胰岛凋亡细胞最少。各治疗组胰岛受损和凋亡严重程度A>B>C。结论30R预混胰岛素治疗方案最佳。提供一个较高的基础胰岛素浓度加少量餐时胰岛素峰值量治疗糖尿病,血糖平稳缓降,对糖尿病胰岛细胞有治疗和保护作用。多次胰岛素3短加1中的强化治疗及太短时间达标的方法不可首选。Objective To investigate the optimal insulin regimens on rabbit diabetes mellitus model according to changes of the islet cell and its apeptosis degree. Methods Rabbit diabetes mellitus models by injection alloxan were divided into 3 groups according to different insulin infusion programs：group A received multiple subcutaneous injection of insulin, group B pre-mixed 50R insulin, group C received pre-mixed 30R insulin. The therapy period was 30 days, the insulin dose and period at the targeted blood glucose level among were observed groups and blood glucose,pathohistology and insulin antibody in un-treatment group and control group were compared. Islets tissue and beta cell apoptosis were marked by hematoxylin-eosin dyeing （HE） and end-labeling （TUNEL）. Results Insulin dose of group B [ （5.62 ±0.67 ）U/kg] is less than those of group A and group C. group C used the largest amount of insulin the targeted blood glucose level. There was significant difference among three groups （P 〈 0.01 ）. The period in group A was the shortest [（7.00±1.31 ） days ] and was in group C the longest [ （19.63 ±1.41 ）days]. There was significant difference among three groups（ P 〈 0.001 ）. Insulin antibody binding rate of group C was significantly higher than those of group B and group C. The damage on beta ceils fimction in group C was the lightest and beta cell apoptosis incidence was the lowest in the same group. The severity degree on islets of langerhans damage and apoptosis in every treated group was A 〉 B 〉 C. Conclusion Subcutaneous injection of pre-mixed 30R may be the optimal insulin treatment protocols,which supplied more basal insulin and less bolus insulin. Intensive insulin therapy by multiple subcutaneous injection of insulin （ triple daily injections short-acting insulin and once daily injection of intermediate-acting insulin or long-acting insulin） was not the recommendation.

关 键 词：糖尿病模型 家兔 胰岛素抗体 HE染色法 

分 类 号：R587.1[医药卫生—内分泌]