初诊2型糖尿病患者胰岛素强化治疗前后海马区NAA/Cr、Cho/Cr的变化  

Changes of Cho/Cr and NAA/Cr in hippocampus,before and after intensive insulin therapy in newly diagnosed type 2 diabetic patients

作　　者：章容[1] 戴武[1] 张继[2] 王松[2] 廖芳芳[3] 叶军[1] 曹永红[1] 刘燕[1] 汪运生[1] 张苏皖[1] 匡蕾[1] 邹玲玲[1] 

机构地区：[1]安徽医科大学附属合肥医院(合肥市第二人民医院)内分泌科,合肥230011 [2]安徽医科大学附属合肥医院(合肥市第二人民医院)磁共振室,合肥230011 [3]安徽医科大学附属合肥医院(合肥市第二人民医院)院感科,合肥230011

出　　处：《安徽医科大学学报》2015年第4期515-518,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省科技厅重点科研项目(编号:12070403043)

摘　　要：目的研究初诊2型糖尿病患者胰岛素强化治疗前后海马区N-乙酰天门冬氨酸复合物（ NAA）/肌酸（ Cr）、胆碱复合物（ Cho）/Cr的变化。方法氢质子磁共振波谱（1 H-MRS）检测30例初诊2型糖尿病患者双侧海马区NAA/Cr、Cho/Cr,同时检测空腹血糖（FPG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（ HbAlc）、三酰甘油（ TG）、胆固醇（ CHO）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、HOMA-β细胞功能指数（ HOMA-β）和HOMA-胰岛素抵抗指数（ HOMA-IR）。胰岛素泵强化降糖10~14 d,血糖达标后复查上述指标予以对比。结果胰岛素强化治疗后,患者 FPG、2 hPG、TG、CHO、LDL、HOMA-IR水平降低（P〈0．05,P〈0．01）,HOMA-β水平升高（ P 〈0．05）；左右侧海马区 NAA/Cr 升高（ P 〈0．05）,右侧海马区 Cho/Cr 降低（ P 〈0．05）,左侧海马区Cho/Cr呈下降趋势,但差异无统计学意义；NAA/Cr、Cho/Cr与血糖、HOMA-β、HOMA-IR有一定相关性。结论胰岛素强化治疗初诊2型糖尿病,可改善患者血糖、血脂,同时可升高双侧海马区NAA/Cr、降低右侧海马区Cho/Cr,其机制可能与血糖降低、胰岛素分泌增加、胰岛素抵抗改善有关。Objective Changes in hippocampus N-acetyl aspartic acid compound （NAA）/creatine（Cr）, choline compound （ Cho）/Cr before and after treatment of intensive insulin in patients with newly diagnosed type 2 diabetes mellitus. Methods Proton magnetic resonance spectroscopy （1H-MRS） was detected in 30 cases of newly diag-nosed type 2 diabetic patients with bilateral hippocampal NAA, Cho and Cr ratio, the simultaneous detection of FPG, 2 hPG, HbAlc, TG, CHO, LDL, HDL, HOMA-β and HOMA-IR. Treated with insulin pump intensive 10~ 14 days, the blood glucose level after the review index was compared. Results After intensive insulin therapy, patients with FPG, 2 hPG, TG, CHO, LDL, HOMA-IR decreased （P〈0. 05,P〈0. 01）, HOMA-βincreased （P〈0. 05 ）; the left and right hippocampus NAA/Cr increased （ P 〈0. 05 ） , the right hippocampus Cho/Cr de-creased （P〈0. 05）, left hippocampus Cho/Cr area decreased, but no statistical difference. The relationship be-tween NAA/Cr, Cho/Cr and blood glucose, HOMA-β, HOMA-IR. Conclusion Intensive insulin therapy in new-ly diagnosed type 2 diabetes can improve blood glucose, blood lipids, and elevate NAA/Cr, bilateral hippocampus decreased Cho/Cr on the right side of the hippocampus, and its mechanism may be related to decrease of blood sug-ar, increase in insulin secretion,insulin resistance improvement.

关 键 词：磁共振波谱 2型糖尿病 胰岛素强化 海马 

分 类 号：R445.2[医药卫生—影像医学与核医学]