初发糖尿病胰岛素强化加用调脂治疗后β细胞早期分泌功能变化研究  

Study of short-term intensive insulin therapy with Lipid-regulating drug on early insulin secretion function of IS-cell in newly diagnosed type 2 diabetes patients

作　　者：杨历新[1] 张亚萍[2] 米娜[1] 王叶[1] 朱沁芳[3] 韩维良[1] 李金娟[3] 李正[1] 

机构地区：[1]青海省人民医院内分泌科,西宁810007 [2]青海省人民医院心内科,西宁810007 [3]苏州大学医学院

出　　处：《中国综合临床》2013年第10期1017-1019,共3页Clinical Medicine of China

基　　金：青海省科技能力建设计划项目（2009-Z-724）

摘　　要：目的研究初发糖尿病胰岛素短期强化治疗加用调脂药物后B细胞功能改变及对血脂的影响。方法初发2型糖尿病患者164例，予以胰岛素强化治疗（CSⅡ），随机分为两组，单纯强化组（n=84），调脂强化组（n=80）在胰岛素强化治疗基础上加用贝特类调脂药物，治疗前行标准OGTT试验，同时测空腹胰岛素、C-肽，餐后胰岛素及C-肽浓度，血脂谱、血压等，2周复查上述指标。比较两组治疗前后血糖（PG），血脂谱、胰岛素抵抗指数（HOMA—IR）、早期胰岛素分泌指数（△C30／△G30）的变化。结果与单纯强化组比较，调脂强化组△C30／△G30无明显改变，差异无统计学意义（17．66±4．18、16．89±4．47，P〉0．05）；甘油三酯（TG）降低明显，差异有统计学意义[（2．50±0．76）mmol／L与（1．80±0．81）mmol／L，P〈0．01）]；HOMA—IR改善明显，差异有统计学意义[2．47±1．98与1．41±1．55，P〈0．01]。结论初发糖尿病患者在胰岛素短期强化治疗加用贝特调脂药物后8细胞早期分泌功能恢复未见进一步好转，但胰岛素抵抗明显改善。Objective To investigate the therapy effect of short-term intensive insulin with Lipid- regulating drug dyslipidemia on early insulin secretion in patients with newly diagnosed type 2 diabetes as well as its effect on blood lipid. Methods One hundred and sixty-four newly diagnosed T2DM patients were selected as subjects and randomly assigned to two groups. One gourp was only insulin treatment group （ n = 84 ） , of which patients all underwent a 14-day course of insulin treatment, and other group was lipid strengthening group （n = 80）, of which patient were treated with Lipid-regulating drug besides insulin. Before treatment, patients were underwent the standard ODT test, and measurement of fasting insulin, C-peptide, postprandial insulin and C- peptide concentration,lipid profile, blood pressure, and recheck all the above indices after 2 weeks. The levels of plasma glucose （ PG）, Lipid, insulin resistance index （ HOMA-IR）, early insulin secretion index （ △C30/△G30） in two groups were detected. Results Compared with the only insulin treatment group, the ration of △C30/△G30 in lipid strengthening group was no obvious change, （ 17. 66 ±4. 18 vs. 16. 89±4. 47,P 〉0. 05）. And the level of triglyceride（TG） was （ 1.80 ±O. 81 ） mmol/L, lower than that of only insulin group （ 2. 50± 0. 76 ） mmol/L. HOMA-IR in lipid strengthening group was improved significantly from （ 2. 47 ± 1.98 ） to （ 1.41± 1.55 ） （ P 〈 0. 01 ）. Conclusion There was no significant improvement in term of early secretion function of beta cells in primary diabetes patients with short-term intensive insulin treatment with lipid-lowering drugs, however insulin resistance was improved significantly.

关 键 词：2型糖尿病 调脂 早期胰岛素分泌 

分 类 号：R587.1[医药卫生—内分泌]