短期胰岛素泵治疗酮症倾向糖尿病疗效分析  

Analysis of Curative Effect of Short-term Insulin Pump in the Treatment of Ketosis-prone Diabetes

作　　者：邓黎[1] 黄文彩[1] 黄文欢[1] 王少波[1] DENG Li;HUANG Wencai;HUANG Wenhuan;WANG Shaobo(Department of Endocrinology,Houjie Hospital,Dongguan,Guangdong Province,523945 China)

机构地区：[1]东莞市厚街医院内分泌科,广东东莞523945

出　　处：《糖尿病新世界》2021年第19期103-105,109,共4页Diabetes New World Magazine

基　　金：东莞市社会科技发展(一般)项目(201950715023725)。

摘　　要：目的探讨短期胰岛素泵强化治疗对酮症倾向糖尿病组织蛋白酶S(CatS)水平影响及大血管病变影响。方法选取2016年3月—2018年2月该院初诊2型糖尿病患者120例进行研究,包括非酮症倾向患者40例,酮症倾向患者80例,根据酮症倾向患者纳入时GAD抗体阳性与否及有无胰岛素β细胞功能残留分为4组,A组(酮症倾向A-β-)、B组(酮症倾向A-β+)、C组(酮症倾向A+β-)、D组(酮症倾向A+β+)各20例,所有患者均给予胰岛素泵强化治疗1~2周,血糖达标及酮体转阴后,继续服用降糖药物或使用胰岛素降糖,对患者随访2年,比较入院时、胰岛素泵强化治疗结束时及随访2年患者血糖水平、白介素-6(IL-6)、C反应蛋白(CRP)、CatS水平及颈动脉内膜厚度(IMT)水平。结果各组强化治疗结束时、随访2年患者空腹血糖、餐后2 h血糖水平,相对入院时显著下降,差异有统计学意义(P<0.05);随访2年,非酮症倾向组患者CatS水平(6.4±1.2)mmol/L显著低于其他4组,差异有统计学意义(P<0.05);随访2年,5组患者颈动脉内膜厚度(0.8±0.2)、(0.9±0.1)、(0.8±0.4)、(0.9±0.3)、(0.9±0.3)mm比入院时均有所降低,差异有统计学意义(P<0.05)。结论短期胰岛素泵强化治疗酮症倾向糖尿病,可降低患者炎症因子和CatS水平,改善患者大血管病变。Objective To investigate the effect of short-term intensive insulin pump therapy on cathepsin S(Cat S) levels in ketosis-prone diabetes and the effect of macrovascular disease.Methods From March 2016 to February 2018,120 patients with type 2 diabetes who were newly diagnosed in the hospital were selected for the study,including 40 patients with nonketosis tendency and 80 patients with ketosis tendency.According to whether the ketosis-prone patients were positive for GAD antibody and whether insulin β-cell function remained at the time of enrollment,they were divided into four groups.Group A(ketosis tendency A-β-),group B(ketosis tendency A-β+),group C(ketosis tendency A+β-),group D(ketosis tendency A +β +),there were 20 cases in each group.All patie nts were given intensive insulin pump therapy for 1 to 2 weeks.After the blood glucose reached the standard and the ketone body became negative,they continued to learn to take hypoglycemic drugs or use insulin to lower blood glucose.Follow up the patient for 2 years,the blood glucose levels,interleukin-6(IL-6),C-reactive protein(CRP),Cat S levels and carotid artery intimal thickness(IMT) levels were compared at the time of admission,at the end of intensive insulin pump treatment and 2 years of follow-up.Results At the end of the intensive treatment in each group,the fasting blood glucose and the blood glucose levels of the patients 2 h after the meal were significantly lowered when they were admitted to the hospital,the difference was statistically significant(P<0.05);after 2 years of follow-up,the Cat S level(6.4±1.2) mmol/L of the non-ketosis-prone group was significantly lower than the other 4 groups,the difference was statistically significant(P<0.05);follow-up for 2 years,the intima thickness of the carotid arteries in the 5 groups was(0.8±0.2)mm,(0.9±0.1)mm,(0.8±0.4)mm,(0.9±0.3)mm,(0.9±0.3)mm was lower than that at admission,the difference was statistically significant(P<0.05).Conclusion Short-term insulin pump intensive treatment of ketosis-prone dia

关 键 词：2型糖尿病 胰岛素泵 酮症 组织蛋白酶S 

分 类 号：R587.1[医药卫生—内分泌]