胰岛素泵对不同病程2型糖尿病患者血管内皮依赖性舒张功能的影响  

Effects of Insulin Pump on Endothelia-dependent Flow-mediated Vasodilatation in Type 2 Diabetes Mellitus Patients in Different Courses

作　　者：牛鑫鑫[1,2] 吕肖锋[1] 高宇[3] 杨鹏飞[1] 郑淑红[1] 

机构地区：[1]北京军区总医院内分泌科,北京市100700 [2]第三军医大学 [3]北京军区总医院超声科,北京市100700

出　　处：《中国全科医学》2010年第35期3967-3969,3972,共4页Chinese General Practice

摘　　要：目的探讨短期胰岛素泵强化治疗对不同病程2型糖尿病患者血管内皮依赖性舒张功能(FMD)的影响。方法选择2型糖尿病患者104例(DM组),按病程分3个亚组:病程<1年(DM1组)38例、1～5年(DM2组)34例、6～10年(DM3组)32例;另选同期健康体检正常者30例(NC组),均接受高频超声检测肱动脉FMD,DM组患者经胰岛素泵强化治疗后复查,同时检测空腹胰岛素并计算胰岛素抵抗指数(HOMA-IR)。结果 (1)DM与NC受检者糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2hPG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、HOME-IR及FMD水平比较,差异均有统计学意义(P<0.05)。(2)2型糖尿病患者胰岛素强化治疗后,FPG、2hPG、TG、TC、LDL-C、HDL-C、HOME-IR水平与治疗前比较,差异均有统计学意义(P<0.05)。(3)DM1组、DM2组患者治疗前后FMD比较,差异均有统计学意义(P<0.01);DM3组患者治疗前后FMD比较,差异无统计学意义(P>0.05)。(4)FMD与HbA1c(r=-0.732,P<0.01)、FPG(r=-0.285,P<0.01)、HOMA-IR(r=-0.573,P<0.01)均呈负相关,与HDL-C呈正相关(r=0.379,P<0.05)。以FMD为因变量,进行多元线性回归分析,得回归方程:FMD=10.685-0.432HbA1c-2.507TG。结论胰岛素泵强化治疗能明显改善短病程2型糖尿病患者的FMD。Objective To invesgate the effects of short term insulin pump therapy on endothelia-dependent flow-mediated dilatation（FMD）in type 2 diabetes mellitus（T2DM）patients in different courses.Methods One hundred four T2DM patients（DM group）were divided,according to course of disease,into subgroups 1-year（DM1 subgroup,n=38）,1～5-year（DM2 subgroup,n=34）,6～10-year（DM2 subgroup,n=32）,and 30 healthy subjects（NC group）were enrolled.All patients received high-frequency ultrasound to determine brachial artery FMD.DM group were reviewed after insulin pump intensification therapy,fasting insulin detected and insulin resistance index（HOMA-IR）calculated.Results There was significant difference between 2 groups in levels of glycosylated hemoglobin（HbA1c）,fasting plasma glucose（FPG）,postprandial 2 h blood glucose（2 hPG）,triglyceride（TG）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,HOME-IR and FMD（P〈0.05）.There was significant difference in levels of FPG、2 hPG、TG、TC、LDL-C、HDL-C、HOME-IR between post-and pre-treatments in DM group（P〈0.05）.There was difference in FMD between pre-and post-treatment in subgroups DM1 and DM2（P〈0.01）,but not in subgroup DM3（P〈0.05）.FMD was negatively correlated with HbA1c（r=-0.732,P〈0.01）,FPG（r=-0.285,P〈0.01）,HOMA-IR（r=-0.573,P〈0.01）,positively with HDL-C（r=0.379,P〈0.05）.Taking FMD as dependent variable to perform multiple linear regression analysis,the regression equation was：FMD=10.685-0.432 HbA1c-2.507TG.Conclusion Insulin pump intensification therapy can improve remarkably FMD in T2DM patients with short-term course of disease.

关 键 词：糖尿病 2型 内皮 血管 胰岛素泵输注系统 

分 类 号：R587.1[医药卫生—内分泌]