胰岛素泵强化治疗对2型糖尿病合并大血管病变患者血清亲环素A、超敏C反应蛋白水平的影响  

Effects of Insulin Pump Intensive Therapy on the Levels of Serum Cyclophilin A and High Sensitivity C Reactive Protein of Type 2 Diabetes Mellitus Patients with Macrovascular Complications

作　　者：向莎[1,2] 吕肖锋[1] 曹怡[1] 武晋晓[1] 陈彬[1] 程千鹏[1] 和瑞婷 赵田[1] 张天瀛[1] 

机构地区：[1]北京军区总医院内分泌科,北京100700 [2]安徽医科大学研究生学院,合肥230032

出　　处：《解放军医药杂志》2016年第5期10-14,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家科技重大专项子课题(2011ZX09307-001-08)

摘　　要：目的探讨胰岛素泵强化治疗对2型糖尿病(type 2 diabetes mellitus,T2DM)合并大血管病变患者血清亲环素A(Cyp A)和超敏C反应蛋白(hs-CRP)水平的影响。方法选择2014年11月—2015年6月在北京军区总医院内分泌科住院行胰岛素泵强化治疗的T2DM患者60例,按照有无大血管病变分为T2DM合并大血管病变(MCV)组(n=30)、T2DM无大血管病变(N-MCV)组(n=30),另选同期在医院体检、经口服葡萄糖耐量试验及相关大血管病变检查均正常的健康者20名作为健康对照(NC)组。对入组者进行临床资料收集,常规生化指标及Cyp A、hs-CRP检测。结果治疗前MCV组血清Cyp A、hs-CRP水平显著高于N-MCV组、NC组(P<0.01);Pearson相关性分析显示,Cyp A与Hb A1c、空腹血糖(FPG)和hs-CRP呈显著正相关(r=0.569、0.495、0.836,P<0.01),hs-CRP与Hb A1c、Cyp A、FPG呈显著正相关(r=0.392、0.296、0.836,P<0.01、P<0.05);胰岛素泵强化治疗后N-MCV组与MCV组FPG、Cyp A和hs-CRP均较治疗前显著下降(P<0.01)。结论血清Cyp A与hs-CRP在T2DM大血管病变发生、发展中可能起重要作用,胰岛素泵强化治疗能显著降低血清Cyp A、hs-CRP水平,对延缓T2DM大血管病变的发展有一定作用。Objective To detect the levels of serum cyclophilin A（ Cyp A） and high sensitive C reactive protein（ hs-CRP） of patients with type 2 diabetes mellitus（ T2DM） associated by macrovascular complications,and to observe the effect of insulin pump intensive therapy.Methods A total of 60 T2 DM patients undergoing insulin pump intensive therapy during November 2014 and June 2015 were divided into macrovascular complications group（ MCV group,n =30） and non-macrovascular complications group（ N-MCV group,n = 30）,and 20 health examination persons undergoing oral glucose tolerance test and macroangiopathy test at the same time were selected as healthy control group（ NC group,n = 20）.Clinical data was collected,and biochemical indexes,serum Cyp A and hs-CRP levels were detected for all patients.Results Before the therapy,the serum Cyp A and hs-CRP levels in MCV group were significantly higher than those in N-MCV and NC groups（ P〈0.01）.Pearson correlation analysis showed that the Cyp A positively correlated with glycated hemoglobin（ Hb A1c）,fasting plasma glucose（ FPG） and hs-CRP（ r = 0.569,0.495 and 0.836,P〈0.01）,and hs-CRP was positively correlated with Hb A1 c,Cyp A and FPG（ r = 0.392,0.296 and 0.836,P〈0.01,P〈0.05）.After the insulin pump intensive therapy,the levels of FPG,Cyp A and hs-CRP were significantly decreased in NMCV and MCV groups compared with those before the therapy（ P〈0.01）.Conclusion Serum Cyp A and hs-CRP may play an important role in the incidence and development of T2 DM patients with MCV.The insulin pump intensive therapy can reduce serum Cyp A and hs-CRP levels,and it may delay the macroangiopathy development of T2 DM patients.

关 键 词：糖尿病 2型 糖尿病血管病变 胰岛素泵输注系统 亲环素A 超敏C反应蛋白 

分 类 号：R587.23[医药卫生—内分泌] R485.5[医药卫生—内科学]