不同胰岛素方案对糖尿病家兔心肌炎症因子及细胞外基质部分成分的影响  

Effects of different insulin regimens on myocardial inflammatory factors and extracellular matrix in diabetic rabbits

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

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

出　　处：《实用医学杂志》2010年第18期3296-3298,共3页The Journal of Practical Medicine

基　　金：广西科学基金(编号:桂科基0385005)

摘　　要：目的:探讨胰岛素(Ins)治疗的适宜方案。方法:雄性家兔40只,随机分成对照组(N组)、糖尿病模型组(D组)、多次Ins治疗组(A组)、50R混合Ins治疗组(B组)、30R混合Ins治疗组(C组)。治疗组用Ins30d后处死动物,同时处死其他组动物;观察各治疗组血糖达标时间及达标时Ins用量。比较各组血糖、糖化血红蛋白(HbA1c)、白天平均血糖水平(MBG)、血糖标准差平均值(MOS)、每只兔血糖绝对差值的平均值(MODD)、肿瘤坏死因子-α(TNF-α)、细胞外基质部分成分(ECM)、NF-κB的表达。结果:A组达标时间最短,C组最长(P<0.01)。治疗组血糖、HbAlc较D组下降(P<005)。A、D两组较C、N组NF-κB灰度值明显降低,TNF-α、ECM明显升高(P<0.05)。A组MOS、MODD较C组N组明显升高(P<0.001);HbA1c与MBG呈正相关(P<0.001)、与MOS、MODD无相关。D组血糖与NF-κB灰度值、HWI呈负相关、与TNF-α呈正相关(均P<0.02)。心脏炎症因子表达明显度D组>A组>B组>C组。结论:较高的基础Ins浓度的30R混合Ins治疗方案最佳。Ins3短加1中或长的强化治疗及太短时间达标的方法不主张首选。Objective To explore the optimal insulin regimens for diabetes mellitus. Methods Fourty male rabbits were randomly divided into group N （control）, group D （diabetic model）, group A （multiple injections of insulin）, group B （premixed 50R insulin）, and group C （premixed 30R insulin）. All the rabbits were sacrificed on day 30. The time to reach the target blood glucose level and the dosage of insulin were recorded in 3 insulin groups. Blood levels of glucose,HbA1c, daytime mean blood glucose （MBG）, blood glucose mean of standard deviation （MOS）, blood glucose mean of definite difference （MODD） for each rabbit, and TNF-α were compared. Extracellular matrix （ECM） and NF-κB expressed were detected. Results The The time to reach the target blood glucose level was the shortest in group A and the longest in group C（P 0 01）. Levels of blood glucose and HbAlc were lower in the insulin groups than in group D. The NF-κB grayscale values were significantly lower while TNF-α and ECM were markedly higher in groups A and D than in groups C and N （P 0.05 for both comparisons）; MOS and MODD were significantly higher in group A than in groups C and N （P 0.001）. HbA1c was positively correlated with MBG（P 0.001）. In group D, blood glucose level was negatively related to HWI and NF-κB grayscale but positively related with TNF-α（P 0.02）. The expression level of inflammatory factors was the highest in group D, followed by groupA, then B and last C. Conclusions Therapy with premixed 30R insulin is the optimal treatment for diabetes. Therapies with three short-acting agents plus one intermediate- or long-acting agent or therapy for reaching the target blood glucose level too quickly should not be used as a primary regimen.

关 键 词：糖尿病 核因子-ΚB 肿瘤坏死因子-Α 细胞外基质 

分 类 号：R587.2[医药卫生—内分泌]