持续6年胰岛素强化治疗对2型糖尿病患者血清炎症因子及颈动脉内-中膜厚度影响的观察  

Effect of six-year intensive insulin therapy on serum levels of inflammatory factors and carotid intima-media thickness in patients with newly diagnosed type 2 diabetes

作　　者：戴尧[1] 陈明卫[1] 张超学[2] 胡红琳[1] 邓大同[1] 王长江[1] 贾敬华[1] 王佑民[1] 

机构地区：[1]安徽医科大学第一附属医院内分泌科,合肥230022 [2]安徽医科大学第一附属医院超声科,合肥230022

出　　处：《中国糖尿病杂志》2014年第5期417-419,共3页Chinese Journal of Diabetes

基　　金：国家中医临床研究基地专项课题(JDZX2012005)

摘　　要：目的观察长期胰岛素强化治疗对新诊断未合并明显动脉粥样硬化(AS)的T2DM患者炎症因子和颈动脉内-中膜厚度(CIMT)的影响。方法30例新诊断T2DM患者胰岛素强化治疗6年,每年检测血清炎症因子高敏C反应蛋白(hsC-RP)、TNF-α、可溶性细胞间黏附分子1(ICAM-1)水平及CIMT。结果随访期间研究对象胰岛素日用量<30U/d,体重、hsC-RP、TNF-α、ICAM-1和胰岛素抵抗指数(HOMA-IR)均先降低后升高。相关性分析显示,CIMT与体重、HbA1c、hsC-RP、TNF-α、ICAM-1和HOMA-IR呈正相关(P<0.05或P<0.01)。结论新诊断未合并明显AS的T2DM患者采用生理剂量胰岛素强化治疗,短期内可减轻慢性炎症,阻止AS发生发展,长期获益还有待研究。Objective To investigate effect of six-year intensive insulin therapy on serum levels of inflammatory factors and carotid intima-r0edia thickness （IMT） in patients with newly diagnosed T2DM without obvious atherosclerosis. Methods Intensive insulin therapy was administered in total thirty patients with newly diagnosed T2DM, and the follow-up lasted for six years. Serum levels of high sensitive C-reactive protein （hsC-RP）, TNF-a and intercellular adhesion molecule-I （ICAM-1） and the values of IMT were all detected per year. Results During the six-year follow-up period, the mean daily dose of insulin was no more than 30 U/d, the values of IMT, body weight, serum levels of hsC-RP, TNF-a, ICAM-1 and HOMA-IR all varied from the declination at first to the raise at last. Correlation analysis showed that there were positive correlations of IMT with body weight, HbA- c, hsC-RP, TNF-a, ICAM-1 and HOMA-IR（P〈0. 05 or P〈0.01）. Conclusion Intensive insulin therapy with physiological dose in patients with newly diagnosed T2DM without obvious atherosclerosis could relieve the degree of inflammatory conditions and protect from atherosclerosis developing during short term. On long terms, the above benefits would not be clear.

关 键 词：糖尿病 2型 胰岛素强化治疗 炎症因子 劲动脉内-中膜厚度 

分 类 号：R587.1[医药卫生—内分泌]