不同胰岛素治疗方案对糖尿病家兔大脑顶叶锥体细胞的影响  

The effect of different insulin regimens on the pyramidal cells in the parietal lobe of diabetic rabbit＇s brain

作　　者：李妮[1] 钟玫[1] 陈晖[1] 莫祥兰[2] 周微雅[3] 陈翠玲[3] 黄莹[3] 

机构地区：[1]广西壮族自治区人民医院内分泌科,广西南宁530021 [2]广西壮族自治区人民医院病理科,广西南宁530021 [3]广西壮族自治区人民医院临床实验室,广西南宁530021

出　　处：《中国医师杂志》2009年第11期1441-1444,共4页Journal of Chinese Physician

基　　金：广西壮族自治区科学技术厅自然科学基金课题（桂科基0385005）

摘　　要：目的以大脑顶叶锥体细胞的变化为判断标准，探讨家兔糖尿病模型胰岛素（Ins）用药治疗的适宜方案。方法40只雄性家兔随机分成5组[对照组（N组）、模型组（D组）、多次Ins治疗组（A组）、50R预混Ins治疗组（B组）、30R预混Ins治疗组（C组）]，其中4组用四氧嘧啶制作成家兔糖尿病模型。治疗组用Ins30d后处死动物，同时处死其他组动物；记录各治疗组血糖达标时间及达标时Ins用量。观察比较各组血糖、脑重、大脑顶叶的锥体细胞凋亡率及病理学变化。结果B组的迭标Ins用量较A、C组少，C组达标时Ins用量最多，差异有统计学意义（P〈001）。A组迭标时间最短（7．00±1．31）d、C组血糖达标时间最长（19．63±1．41）d，各组间差异有统计学意义（P〈0.01）。结束时的体重与血糖呈负相关（r=-0．559，P〈0．01），脑重量与血糖亦呈负相关（r=-0．656，P〈0．01）。模型组绝大多数神经元变性凋亡，与其他各组比较差异有统计学意义（P〈0．01）。各治疗组大脑顶叶皮质锥体细胞组织水肿及病变受损严重程度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，对糖尿病神经组织有治疗和保护作用。多次胰岛素3短加1中或长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 according to the pyramidal cells＇change in the parietal lobe of brain on rabbit diabetes mellitus model. Methods Forty male rabbit were random divided into 5 group, including control group （ group N）, model group （group D）, group received multiple subcutaneous injection of insulin （group A）, group received isophane protamine biosynthetic human injection （pre-mixed 50R） （group B）, group received isophane protamine biosynthetic human injection （pre-mixed 30R） （group C）. Homemade rabbit diabetes mellitus models induced by alloxan were divided into 4 groups. After 30 day, therapy group treated with insulin inject were put to death. Other group animal were sacrificed at the same time. The insulin dose and period at the targeted blood glucose level among 3 insulin groups, blood glucose, brain weight, the rate of apoptosis of the pyramidal cells and pathohistology change in the parietal lobe of the brain between untreated group and control groups were compared. Results Insulin dose needed by group B is less than group A and C. The largest amount of insulin was used in group C to get to the targeted blood glucose levels. There was significant difference among 3 groups （ P 〈0. 01 ）. The period in group A was shortest （7.00 ± 1.31 days ） and longest in C group （ 19.63 ± 1.41 days ）. At the end of the investigation, the body weight was negatively related to the blood glucose （ r = - 0. 559, P 〈 0. 01 ）, the brain weight was also negatively related to the blood glucose （ r = - 0. 656, P 〈 0. 01 ）. Most of the neurons were degenerate and apoptotic in model group, which had significant difference among 3 groups（ P 〈0. 01 ）. The severity of edema and damage on cortex pyramidal cells in the brain in control groups is A 〉 B 〉 C. Conclusions Subcutaneous injection of pre-mixed 30R may be the optimal insulin treatment protocol. This regimen supplies more basal insulin and less bolus insulin. The blood glucose dr

关 键 词：胰岛素/投药和剂量 糖尿病 实验性/药物疗法/病理学 锥体细胞/药物作用 

分 类 号：R285.5[医药卫生—中药学]