持续皮下胰岛素注射对糖尿病视网膜病变影响的研究进展  

The efficacy of continuous subcutaneous insulin infusion in patients with diabetic retinopathy

作　　者：沈璇 顾云娟[2] SHEN Xuan;GU Yun-juan(Department of Medicine,Nantong University,Nantong 226001,China;Department of Endocrinology and Metabolism,the Affiliated Hospital of Nantong University)

机构地区：[1]江苏省南通市南通大学医学院,226001 [2]南通大学附属医院内分泌与代谢科

出　　处：《天津医药》2019年第11期1189-1196,共8页Tianjin Medical Journal

基　　金：江苏省研究生科研与实践创新计划项目(SJCX18_0824);江苏省六大人才高峰高层次人才C类资助项目(2016-WSN-098);南通市科技计划项目(HS2014036);上海市糖尿病重点实验室开放课题资助(SHKLD-KF-1303)

摘　　要：胰岛素强化治疗对糖尿病视网膜病变(DR)结局的影响一直存在争议。著名的大型研究如糖尿病控制与并发症试验(DCCT)/糖尿病干预及并发症流行病学(EDIC)研究和英国前瞻性糖尿病研究(UKPDS)已经表明,1型或2型糖尿病(T1DM/T2DM)患者通过胰岛素强化治疗可在短期内使患者的血糖达标,延缓糖尿病视网膜病变的发生和进展,但一些研究发现对血糖控制不佳T1DM患者进行强化治疗中会发生一过性糖尿病视网膜病变加重。诸多大型研究多采用皮下多点注射(MDI)模式进行胰岛素强化治疗,而短期持续皮下胰岛素注射(CSII)治疗对T2DM视网膜病变的长期疗效的研究报道国内外尚不多见。本文就CSI I治疗对DR发生发展影响的相关研究进展及发展趋势进行综述。The effect of insulin intensive therapy on the outcome of diabetic retinopathy(DR)has been controversial all the time.The famous multicenter,randomized trials such as diabetes control and complications trial(DCCT)/the observational epidemiology of diabetes interventions and complications(EDIC)study and UK prospective diabetes study(UKPDS)have demonstrated that course of intensive therapy can successfully make good glycemic control in the short time and lay a foundation for the prolongation of the progression of DR.However,it has also found that tightening of glucose control can trigger transient progression(early worsening)of diabetic retinopathy in type 1 diabetes mellitus(T1DM)with poor glycemic control.In such studies,multiple daily insulin injection(MDI)was used for intensive therapy instead of continuous subcutaneous insulin infusion(CSII),and the protracted effect of CSII on DR for type 2 diabetes mellitus(T2DM)should be further investigated.Here,we summarized and reviewed the progress of insulin pump therapy in the occurrence and development of diabetic retinopathy.

关 键 词：糖尿病视网膜病变 持续皮下胰岛素注射 胰岛素泵 强化治疗 综述 

分 类 号：R587.1[医药卫生—内分泌] R774.1[医药卫生—内科学]