胰岛素泵对初诊2型糖尿病患者内皮依赖性舒张功能及3-硝基酪氨酸的影响  

Effects of Insulin Pump on Endothelia-dependant Flow-mediated Vasodilatation and Serum 3-nitrotyrosine in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

作　　者：牛鑫鑫[1,2] 吕肖锋[1] 高宇[3] 杨鹏飞[1] 王素玲[1] 武晋晓[1] 焦秀敏[1] 张星光[1] 赵晶[1] 姚璐[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]第三军医大学超声科

出　　处：《中国全科医学》2011年第11期1222-1224,共3页Chinese General Practice

摘　　要：目的探讨胰岛素泵强化治疗对初诊2型糖尿病(T2DM)患者血管内皮依赖性舒张功能(FMD)及血清3-硝基酪氨酸(3-NT)的影响。方法选取初诊T2DM患者40例(DM组)及与其年龄、性别等指标相匹配的健康体检者30例(NC组)。检测两组受检者的血清学指标(包括血糖、血脂、糖化血红蛋白等),采用高分辨率超声仪检测FMD,采用酶联免疫吸附法(ELISA)检测血清3-NT水平。另外,DM组加测空腹胰岛素(FINS),采用稳态模型计算胰岛素抵抗指数(HOMA-IR)。DM组经胰岛素泵强化治疗2周后复测上述指标。结果 (1)与NC组比较,DM组患者的高密度脂蛋白胆固醇(HDL-C)水平及FMD显著下降,而糖化血红蛋白、血糖、血脂(除外HDL-C)及血清3-NT水平均显著增高,差异有统计学意义(P<0.05)。(2)DM组经胰岛素泵强化治疗2周后,FMD由治疗前的(4.54±1.42)%增高至治疗后的(7.20±2.59)%,血清3-NT水平由治疗前的(118±13)nmol/L降低至治疗后的(112±11)nmol/L,差异均有统计学意义(P<0.01)。(3)相关分析显示,血清3-NT水平与糖化血红蛋白、空腹血糖呈正相关(P<0.01),与FMD呈负相关(P<0.01)。结论胰岛素泵强化治疗能明显提高初诊T2DM患者的FMD,降低血清3-NT水平。Objective To investigate the effects of short-term insulin pump therapy on flow-mediated dilatation（FMD） and serum 3-NT concentration in patients with newly diagnosed type 2 diabetes mellitus.Methods 40 patients with newly diagnosed type 2 diabetes mellitus were selected as DM group and 30 age-and sex-matched healthy people were selected as NC group.In the two groups,blood sugar,blood fat and glycosylated hemoglobin were tested,FMD was tested by high resolution ultrasound detection,and serum 3-NT concentration was tested by enzyme linked immunosorbent assay（ELISA） detection.Besides,fasting insulin was measured and HOMA-IR was calculated in DM group.After intensive therapy by insulin pump for 2 weeks,FMD and serum 3-NT concentration were reexamined in DM group.Results（1） Compared with the NC group,the T2DM group had significantly lower HDL-C and FMD,and higher glycosylated hemoglobin,blood glucose and blood fat as well as serum 3-NT concentration（P0.05）.（2）After two-week insulin pump therapy,FMD in DM group increased from（4.54±1.42）% to（7.20±2.59）%（P0.01）,serum 3-NT concentration decreased from（118±13）nmol/L to（112±11）nmol/L（P0.01）.The difference was statistically significant（P0.01）.（3） Correlation analysis showed that 3-NT level had positive correlation with glycosylated hemoglobin and fasting plasma glucose but negative correlation with FMD（P0.01）.Conclusion Intensive treatment by insulin pump can increase FMD and decrease 3-NT concentration in patients with newly diagnosed type 2 diabetes mellitus.

关 键 词：糖尿病 2型 3-硝基酪氨酸 血管内皮依赖性舒张功能 胰岛素泵强化治疗 

分 类 号：R587.1[医药卫生—内分泌]