胰岛素泵强化治疗对初诊2型糖尿病患者炎症因子水平的影响  

The effects of short-term intensive treatment with insulin pump on levels of inflammatory factors in newly diagnosed type 2 diabetes

作　　者：陶松桔[1] 尹支农[2] 宋卫红[1] 张亚萍[1] 伍蔚凌[1] 

机构地区：[1]湖南省郴州巿第一人民医院内分泌糖尿病科,423000 [2]湖南省郴州巿第一人民医院药剂科,423000

出　　处：《中国临床研究》2010年第1期11-13,共3页Chinese Journal of Clinical Research

基　　金：郴州巿第一人民医院科研基金资助项目(2008-062)

摘　　要：目的观察初诊2型糖尿病(T2DM)患者体内炎症状态及短期持续皮下胰岛素输注(CSII)治疗对T2DM患者体内炎症因子水平的影响。方法60例初诊T2DM患者接受为期2周的CSII强化治疗,于治疗前、后测定血清炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)浓度,同时测定T2DM患者空腹胰岛素水平,采用稳态模型计算胰岛素抵抗指数(HOMA-IR),并选择基线资料匹配的50例体检健康者作为对照组。结果(1)与对照组比较,T2DM患者炎症因子IL-6(P<0.01)、TNF-α(P<0.05)、CRP(P<0.05)显著增高。(2)炎症因子IL-6、TNF-α、CRP与HOMA-IR呈正相关(r1=0.6071,P<0.05;r2=0.8033,P<0.01;r3=0.7435,P<0.01)。(3)CSII治疗2周后炎症因子IL-6、TNF-α、CRP明显降低(P均<0.05),HOMA-IR明显降低(P<0.01)。结论新诊断的T2DM患者处于慢性炎症状态,这种炎症状态与胰岛素抵抗形成有关,短期CSII治疗除降低血糖外,能显著降低T2DM患者的炎症因子水平,改善炎症,减轻胰岛素抵抗。Objective To observe the inflammatory state in newly diagnosed type 2 diabetes（T2DM） patients and the effect of short-term continuous subcutaneous insulin injection（CSII） therapy on inflammatory factors level.Methods Sixty cases of newly diagnosed T2DM（DM goup）received CSII therapy for two weeks,and 50 baseline data-matched healthy subjects were selected as control group.Inflammatory factors of pre-and post-treatment including interleukin 6（IL-6）,tumor necrosis factor-α（TNF-α） and C-reactive protein（CRP） concentrations were examined,and insulin resistance indexes（HOMAIR） with homeostasis model were simultaneously determined in patients with T2DM.Results（1） The levels of IL-6,TNFα,CRP were significantly higher（65.67 ±14.50） vs（40.95 ±11.30） ng/L,P 〈0.01;（80.35 ±12.35） vs（60.08 ± 10.53） ng/L,P 〈 0.05;（7.45 ± 0.85） vs（6.32 ± 0.53） ng/L,P 〈 0.05;respectivelyin DM group than those in control group.（2） There were significant positive correlations between IL-6（r=0.6071,P 〈 0.05）,TNF-α（r=0.8033,P 〈 0.01）,CRP（r=0.7435,P 〈 0.01） and HOMA-IR.（3） After 2 weeks CSII treatment,IL-6（50.67 ± 11.50） vs（65.67 ± 14.50） ng/L,P 〈 0.05,TNF-α（68.33 ± 10.54） vs（80.35 ± 12.35） ng/L,P 〈 0.05,CRP（5.58 ± 0.63） vs（7.45 ± 0.85） mg/L,P 〈 0.05and HOMA-IR（6.50 ± 1.80）% vs（8.90 ± 3.70）% ,P 〈 0.01were all significantly decreased than those before treatment.Conclusions Newly diagnosed T2DM patients were in a state of chronic inflammation,and the inflammatory state was correlated with formation of insulin resistance.Short-term CSII therapy in addition to lowering blood glucose can significantly reduce inflammatory factors,ameliorate the role of inflammation,reduce insulin resistance in patients with T2DM.

关 键 词：糖尿病 2型 炎症因子 持续皮下胰岛素注射 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]