短期胰岛素泵强化治疗对2型糖尿病患者内皮依赖性血管舒张功能的影响  

Effects of short term insulin pump therapy on endothelia-dependant flow-mediated dilation intype 2 diabetes memtus patients

作　　者：杨鹏飞[1] 吕肖锋[1] 高宇[2] 牛鑫鑫[1] 

机构地区：[1]北京军区总医院内分泌科,100070 [2]北京军区总医院超声科,100070

出　　处：《中国医师进修杂志》2011年第13期11-14,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨短期胰岛素泵强化治疗对合并及不合并有大血管并发症的2型糖尿病（T2DM）患者内皮依赖性血管舒张功能（FMD）的影响.方法 选择T2DM患者76例（T2DM组）,分为两个亚组,合并有大血管并发症者28例（T2DM1组）,无大血管并发症者48例（T2DM2组）,另选年龄、性别相匹配的健康对照者30例（NC组）,所有对象均接受高频超声检测肱动脉血管FMD,T2DM组经胰岛素泵强化治疗后复查.同时检测血糖、血脂、空腹胰岛素及其他代谢指标,并计算稳态模型法胰岛素抵抗指数（HOMA-IR）.结果 与NC组比较,T2DM组患者FMD显著下降（P＜0.01）,而糖化血红蛋白（HbA1c）、空腹血糖（FPG）、HOMA-IR、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆同醇（LDL-C）显著增高（P＜0.01或＜0.05）.相关分析显示FMD与HbAI1c、FPG、HOMA-IR、TG、LDL-C呈负相关（P＜0.01）.与高密度脂蛋白胆同醇（HDL-C）呈正相关（P＜0.01）.T2DM组经胰岛素泵强化治疗2周后.两个亚组患者FMD改善效果不同,T2DMl组由治疗前（4.25±1.96）%增至治疗后（4.96±1.36）%（P＞0.05）,T2DM2组由治疗前（4.02±2.35）%增至治疗后（7.56±2.34）%（P＜0.01）.结论 短期胰岛素泵强化治疗能明显改善不合并有大血管并发症T2DM患者的FMD.Objective To investigate the effects of short term insulin pump intensive therapy on flow-mediated dilation （FMD） in type 2 diabetes mellitus （T2DM） patients with and without vascular complications. Methods Seventy-six patients with T2DM （T2DM group） were divided into 2 subgroups： T2DM1 subgroup （28 patients with vascular complications） and T2DM2 subgroup （48 patients without vascular complications）. Meanwhile, 30 healthy cases were selected as NC group. All research subjects accepted high-frequency ultrasound detection on brachial artery for FMD. After insulin pump intensive therapy,FMD in T2DM group was reexamined, fasting insulin was detected and HOMA-IR was calculated. Results Compared with that in NC group, FMD in T2DM group was significantly lower（P〈 0.01）. However, glycosylated hemoglobin （HbA1c ）, fasting plasma glucose （FPG ）,H0MA-IR and blood fat were significantly higher （P〈0.01 or 〈0.05）. Correlation analysis showed that FMD had negative correlation with HbA1c, FPG, HOMA-IR, triglyceride （TG） and low-density lipoprotein cholesterol （LDL-C）（P〈0.01）,and had positive correlation with high-density lipoprotein cholesterol （HDL-C）. After 2 weeks of insulin pump therapy, the improvement of FMD between the two groups was different. FMD in T2DM1 subgroup increased from （4.25 ± 1.96）% to （4.96 ± 1.36）%（P〉0.05）, and FMD in T2DM2 subgroup increased from （4.02 ± 2.35）% to （7.56 ± 2.34）%（P〈 0.01）. Conclusion Insulin pump intensive therapy can evidently improve FMD in T2DM patients without vascular complications.

关 键 词：胰岛素输注系统 糖尿病 2型 血管舒张 

分 类 号：R587.1[医药卫生—内分泌]