不同胰岛素治疗方案对糖尿病家兔脑组织及炎症因子的影响  

Effects of different insulin regimens on the inflammatory factors in diabetic rabbit's brain tissue

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：《中国现代医学杂志》2009年第24期3713-3717,共5页China Journal of Modern Medicine

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：目的以脑组织核因子-κB(NF-κB)表达和血清肿瘤坏死因子-α(TNF-α)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、脑组织含水量、脑组织核转录因子-κB(NF-κB)肿瘤坏死因子-α(TNF-α)、大脑顶叶组织片病理学变化。结果B组的达标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<0.01)。A组达标时间最短(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)。实验结束时,治疗组空腹血糖、HbA1c、TNF-α较D组下降,差异有统计学意义(P<0.05);NF-KB灰度值较D组增高(P<0.05);脑组织含水量A组明显升高,差异有统计学意义(P<0.05)。治疗组脑组织含水量、TNF-α与血糖呈负相关(r=-0.44、-0.77;P<0.05);脑NF-κB灰度值与血糖呈正相关(r=0.52;P<0.01)。模型组脑组织含水量、脑NF-κB灰度值与血糖呈负相关(r=-0.81、-0.86;P<0.05);TNF-α与血糖呈正相关(r=0.79,P<0.02)。大脑顶叶皮质锥体细胞组织水肿及病变受损严重程度D>A>B>C。结论30R预混胰岛素治疗方案最佳。提供1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 on Rabbit Diabetes Mellitus Model according to expression of nuclear factor kappa B （NF-κB） in the brain tissue and the level of tumor necrosis factor-alpha （TNF-α）.【Methods】40 alone male rabbits were divided random into 5 group [control group （N group）,model group （D group）,A group received multiple subcutaneous injection of insulin,B group adopted isophane protamine biosynthetic human injection （pre-mixed 50R）,C group received isophane protamine biosynthetic human injection （premixed 30R）.Homemade rabbit Diabetes Mellitus Models induced by Alloxan were divided into 4 groups.After 30 day,therapy group to inject insulin treatment were sacrifeced.Other group animal were died at the same time.We observed the blood glucose levels,the water content of the brain,TNF-α,the parietal lobe tissue of the brain and analysed the expression of NF-κB in the brain tissue by immunohistochemistry.The value of inspected was comparied to that of untreated group and control groups.【Results】Insulin dose of B group is less than A group and C group.C group used the largest amount of insulin to get to the targeted blood glucose levels.There was significant difference among 3 groups （P 〈0.01）.The period was Shortest in A group （7.00 ± 1.31 days） and longest in C group （19.63 ± 1.41 days）.There was significant difference among 3 groups （P 〈0.001）.At the end of the investigation,blood-fasting,HbA1c,TNF-α were descend;gray scale of NF-KB was heighten in treatment group.the water content of the brain was obviously high in A group.There was statistical significance in difference （P 〈0 01）.The blood glucose were positively related to the water content of the brain,but negatively related to TNF-α （r =-0.44,-0.77,P 〈0.05）,the blood glucose were positively related to the NF-κB gradation value （r =0.52;P 〈0.01） in insul in therapy group;The blood glucose were negatively related to the water content of the brain,

关 键 词：糖尿病家兔模型 HE染色法 核因子-ΚB 肿瘤坏死因子-Α 

分 类 号：R587.1[医药卫生—内分泌]