短期持续皮下胰岛素输注强化治疗初诊2型糖尿病患者的疗效  

Therapeutic Effects of Insulin with Short-term Continuous Subcutaneous Infusion in Newly Diagnosed Type 2 Diabets

作　　者：陈德清[1] 钟宇华[1] 曾云先[1] 梁华晟[1] 

机构地区：[1]广西医科大学第九附属医院内分泌科,广西北海536000

出　　处：《江西医学院学报》2009年第9期45-48,共4页Acta Academiae Medicinae Jiangxi

摘　　要：目的探讨短期持续皮下胰岛素输注(continuous subcutaneous insulin infusion,CSII)强化治疗对初诊2型糖尿病患者中远期的临床疗效。方法回顾性分析118例初诊为2型糖尿病的患者经CSII强化治疗2周后血糖控制、胰岛素敏感性和分泌功能,不服用药物血糖达标持续时间(缓解期)等。结果CSII强化治疗2周后118例患者HbA1C、FPG、2hPG、HOMA-IR下降明显(P<0.01);FC-P、2hC-P、HOMA-β、△C30/△G30(早期胰岛素分泌指数)、△C120/△G120(2h后胰岛素分泌指数)明显提高(P<0.01)。拆除胰岛素泵缓解期超过2个月的患者共98例(83.0%),超过6个月75例(63.0%),超过12个月16例(13.5%)。结论短期CSII强化治疗使血糖"正常化",同时可改善胰岛β细胞功能,提高胰岛素敏感性,诱导出血糖控制长期良好而不需服用降血糖药物的缓解期。Objective To investigate the therapeutic effects of short-term continuous subcutaneous insulin infusion in newly diagnosed type 2 diabets.Methods By way of follow-up and retrospective study,118 patients with newly diagnosed tpye 2 diabetes mellitus received two week of CSII therapy and the effects were analyzed in our diabetes center.The parameters,such as blood glucose level after two-week CSII therapy,insulin secretion and sensitivity,time needed to control hyperglycemia,insulin dosage and the rate of hypoglycemic episodes were observed and recorded.Results HbA1C,FPG,2 hPG,HOMA-IR were significantly reduced（all P0.01）;FC-P,2 hC-P,HOMA-β,C30/G30,C120/G120 were significantly increased（all P〈0.01）.The remission rates of patients who maintained optimal glycemic control at the second,sixth,and twelfth-months were 83.0%,63.0%,13.5%,respectively.Conclusion Normalization of blood glucose levels by transient intensive CSII therapy improves pancreas β-cell function and insulin sensitivity,which seems to contribute to the long-term diabetic remission.

关 键 词：糖尿病 2型 持续皮下胰岛素输注 胰岛素抵抗 

分 类 号：R587.2[医药卫生—内分泌]