胰岛素泵治疗对初诊2型糖尿病患者血糖、血脂、氧化应激的影响及胰岛β细胞与超氧化物歧化酶的关系研究  

Influence of Insulin Pump Treatment on the Level of Blood Glucose,Serum Lipids,Oxidative Stress and the Relation between Islet β Cell and Superoxide Dismutase in Newly Diagnosed Type 2 Diabetic Patients

作　　者：赵国莉[1] 吕肖峰[1] 程千鹏[1] 

机构地区：[1]北京军区总医院内分泌科,北京市100700

出　　处：《中国全科医学》2012年第25期2902-2904,共3页Chinese General Practice

摘　　要：目的探讨胰岛素泵持续皮下胰岛素输注(CSII)对初诊2型糖尿病(T2DM)患者血糖、血脂、氧化应激的影响及胰岛β细胞与超氧化物歧化酶(SOD)的关系。方法对空腹血糖(FPG)≥10 mmol/L,未使用过口服降糖药物或胰岛素治疗的初诊T2DM患者60例,进行为期14 d的CSII治疗。分别于治疗前后测定患者血清FPG、餐后2 h血糖(2 hPG)、糖化血清蛋白(GA)、空腹胰岛素(FINS)、三酰甘油(TG)、SOD、丙二醛(MDA)水平,计算胰岛素抵抗指数(HOMA-IR)及胰岛素分泌指数(HOMA-β)。结果 (1)CSII治疗后患者的FPG、2 hPG、GA、TG、MDA均较治疗前下降,SOD水平较治疗前升高,差异均有统计学意义(P<0.01)。(2)CSII治疗后患者的HOMA-IR低于治疗前,HOMA-β高于治疗前,差异有统计学意义(P<0.01)。(3)多元线性回归分析表明,HOMA-β与SOD水平呈正相关(R=0.51,R2=0.26,P<0.01)。结论对伴有明显高血糖的初诊T2DM患者,胰岛素泵强化治疗可以有效控制血糖,降低血脂,有效改善胰岛素抵抗,恢复胰岛β细胞功能,且增加SOD水平,从而改善氧化应激对胰岛β细胞功能的损伤。Objective To explore the influence of continuous subcutaneous insulin infusion （CSII） on the level of blood glucose, serum lipids, oxidative stress and the relation between islet 13 cell and superoxide dismutase （SOD） in newly di- agnosed type 2 diabetic patients. Methods A total of 60 newly diagnosed T2DM patients who had fasting plasma glucose （FPG） ≥10 mmol/L and had never been treated with oral antidiabetic drugs or insulin were included and treated with insulin pump for 14 days. FPG, 2 hour postprandial plasma glucose （ 2 hPG ） , glycated albumin （ GA ） , fasting insulin （ FINS ） , triacylglycerol （TG） , SOD and malonaldehyde （MDA） were measured before and after insulin pump treatment. Insulin resistance index （HO- MA -IR） and insulin secretion index （HOMA - β） were compared before and after the treatment. Results The level of FPG, 2 hPG, GA, TG, MDA and HOMA - IR were significant lower （P 〈0. 01 ）, while SOD and HOMA - β were significantly im- proved （P 〈0. 01 ） after the treatment. HOMA -13 was positively associated with the SOD level （R = 0. 51, R2 = 0. 26, P 〈 0. 01 ） . Conclusion In newly diagnosed T2DM with severe hyperglycemia, intensive insulin pump treatment could effectively control the blood sugar and fat, improve insulin resistance, restore pancreatic β cells function and increase the SOD level, which can reduce the damage to pancreatic β cells caused by oxidative stress.

关 键 词：糖尿病 2型 胰岛素 血糖 血脂 胰岛Β细胞 氧化应激 

分 类 号：R587.1[医药卫生—内分泌]