高压氧对糖尿病微血管病变干预作用的临床研究  

Clinical intervention research of hyperbaric oxygen on diabetic microangiopathy

作　　者：黄锦欢[1] 李德干[2] 王冰[3] 孙鹏飞[1] 张俊林[1] 李平[4] 张原琪[5] 张健[6] 

机构地区：[1]广西壮族自治区玉林市第二人民医院内分泌科,广西玉林537000 [2]广西壮族自治区玉林市第二人民医院中西医结合内科,广西玉林537000 [3]广西壮族自治区玉林市第二人民医院心血管内科,广西玉林537000 [4]广西壮族自治区玉林市第二人民医院眼科,广西玉林537000 [5]广西壮族自治区玉林市第二人民医院检验科,广西玉林537000 [6]广西壮族自治区玉林市第二人民医院高压氧科,广西玉林537000

出　　处：《中国现代医学杂志》2010年第19期2984-2987,2990,共5页China Journal of Modern Medicine

基　　金：广西玉林市玉市科攻项目(No:0866005)

摘　　要：目的探讨高压氧对糖尿病微血管病变的干预作用及其可能机制。方法选择符合观察对象的初诊2型糖尿病患者76例,随机分为治疗组(38例)和对照组(38例),两组均按相对统一的常规糖尿病综合治疗方案治疗,在此基础上,治疗组同时加予高压氧治疗,每天1次,10次为1疗程,连续2个疗程。每隔半年做2个疗程,治疗并观察3年,定期监测空腹及餐后2h血糖及糖化血红蛋白(HbA1c),每年检查眼底及尿微量白蛋白排泄率(UAER)。结果治疗前两组眼底检查未见异常,UAER<20μg/min,两组血糖、HbA1c、UAER、血脂及胰岛素抵抗指数(Homa-IR)等差异无显著性。治疗3年后,两组血糖、HbA1c、Homa-IR及血脂逐渐下降,但治疗组下降更显著,两组比较差异有显著性(P<0.05或P<0.01);3年末治疗组有1例进展为糖尿病视网膜病(Ⅰ期),占2.63%,对照组有8例进展为糖尿病视网膜病变(Ⅰ期5例,Ⅱ期3例),占21.05%,两组比较差异有显著性(P<0.05);3年末治疗组UAER为(16.69±2.17)μg/min,对照组UAER为(20.63±2.77)μg/min,两组比较差异有显著性(P<0.01)。3年未治疗组有3例进展为早期糖尿病肾病,占5.26%,对照组有16例进展为早期糖尿病肾病,占28.95%,两组比较差异有显著性(P<0.05)。结论高压氧可有效改善糖尿病患者的代谢紊乱,降低胰岛素抵抗,能预防和延缓糖尿病微血管病变的进展,对糖尿病微血管病变有较好的干预作用。【Objective】To study the intervention effect of hyperbaric oxygen on diabetic microangiopathy and its possible mechanism.【Methods】Seventy-six patients with type 2 diabetes mellitus were selected and randomly divided into the treated group（38 cases） and the control group（38 cases）.The patents in the two groups were both treated with the routine diabetic therapy;and the ones in the treated group additionally received the hyperbaric oxygen treatment,which consisted of several courses and lasted for 3 years,each course made up of 10 times（once a day） and continued two courses were done every half year.Fasting and 2-hour postprandial blood glucose and glycated hemoglobin（HbA1c）,an annual inspection eyeground and urinary albumin excretion rate（UAER） were regularly monitored.【Results】Before treatment in the two groups eyeground examination revealed no abnormality,UAER was less than 20 μg/min;the blood glucose,HbA1c,UAER,blood lipids,insulin resistance index（HOMAIR） showed no significant difference between both groups.After treatment for three years,blood glucose,HbA1c,HOMA-IR and serum lipids in both groups gradually decreased,but in the treatment group the decrease was more significant（P〈0.05）.After 3 years,in the treated group,1 case progressed to diabetic retinopathy（stage Ⅰ）,accounting for 2.63%;and in the control group,8 cases progressed to diabetic retinopathy（5 casesⅠ,3 cases of stageⅡ）,accounting for 21.05%;there was a significant difference between both groups（P〈0.05）.UAER in the treated group was（16.69 ±2.17） μg/min and UAER in the control group was（20.63 ±2.77） μg/min,there was significant difference between both groups（P〈0.05）.In the treated group,3 cases progressed to early diabetic nephropathy,accounting for 5.26%;and in the control group,16 cases progressed to early diabetic nephropathy,accounting for 28.95%,there was a significant difference between both groups（P〈0.05）.【Conclusion】 Hyperbaric oxygen can safely and e

关 键 词：高压氧 2型糖尿病 微血管病变 干预 

分 类 号：R587.1[医药卫生—内分泌]