上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

2型糖尿病患者短期胰岛素泵强化治疗期间胰岛β细胞功能的变化

王卫东1，滕军儒2，邢 林1，李 硕1，米 娜1，刘 玉1   

  1. 济南市第三人民医院 1.内分泌科， 2.检验科， 济南 250132
  • 出版日期:2014-12-28 发布日期:2014-12-30
  • 作者简介:王卫东（1973—）， 男， 硕士生; 电子信箱: wsrsy1973@163.com。

Variations of islet β cell function during short-term intensive insulin pump treatment for patients with type 2 diabetes mellitus

WANG Wei-dong1, TENG Jun-ru2, XING Lin1, LI Shuo1, MI Na1, LIU Yu1   

  1. 1.Department of Endocrinology， 2.Clinical Laboratory， the Third People's Hospital of Jinan， Jinan 250132， China
  • Online:2014-12-28 Published:2014-12-30

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摘要：

目的 观察2型糖尿病患者短期胰岛素泵强化治疗期间胰岛β细胞功能的变化。方法 将2型糖尿病患者120例随机分为观察组和对照组，每组各60例。对照组采用口服降糖药控制血糖，观察组采用胰岛素泵短期强化治疗。接受4周的治疗后，比较两组患者治疗前后血糖、血脂以及胰岛功能相关指标。结果 经过治疗后，两组患者的空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、胰岛素抵抗指数（HOMA-IR）均显著低于治疗前（均P<0.05）；而空腹C肽（FCP）、餐后2小时C肽（CP2h）、高密度脂蛋白胆固醇（HDL-C）、胰岛素分泌指数（HOMA-β）则显著高于治疗前（均P<0.05）。治疗后，观察组FPG、2hPG、HbA1c、TC、TG、LDL-C均显著低于对照组（均P<0.05），FCP、CP2h、HDL-C均显著高于对照组（均P<0.05）。治疗后，观察组HOMA-IR显著低于对照组（P<0.05），而HOMA-β显著高于对照组（P<0.05）。结论 短期胰岛素泵强化治疗能迅速稳定2型糖尿病患者血糖水平，有助于患者胰岛β细胞功能的恢复，改善患者机体胰岛素抵抗和脂质代谢紊乱状态。

关键词: 2型糖尿病, 胰岛素泵, 强化治疗, 胰岛β细胞

Abstract:

Objective To observe variations of functions of islet β cells during the short-term insulin pump intensive treatment for patients with type 2 diabetes mellitus. Methods A total of 120 cases of type 2 diabetes mellitus were randomly divided into the observation group and control group with 60 cases in each group. Patients of the control group administrated oral antidiabetic drugs to control the blood glucose, while patients of the observation group were treated by the intensive insulin pump. After 4 weeks of therapy, the blood glucose, blood lipid, and relevant indicators of insulin function of two groups before and after the treatment were compared. Results After treatment, fasting blood glucose (FPG), 2 h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and insulin resistance index (HOMA-IR) of two groups were significantly lower than those before the treatment (P<0.05), while fasting C peptide (FCP), 2 h postprandial C peptide (CP2h), high density lipoprotein cholesterol (HDL-C), and insulin secretion index (HOMA-β) were significantly higher than those before the treatment (P<0.05). After treatment, the FPG, 2hPG, HbA1c, TC, TG, and LDL-C of the observation group were all significantly lower than those of the control group (P<0.05), while the FCP, CP2h, and HDL-C were significantly higher than those of the control group (P<0.05). The HOMA-IR of the observation group was significantly lower than that of the control group (P<0.05), while the HOMA-β was significantly higher than that of the control group (P<0.05). Conclusion The short-term intensive insulin pump treatment can quickly stabilize the blood glucose level of patients with type 2 diabetes mellitus, contribute to recovering functions of islet β cells, and alleviate the insulin resistance and lipid metabolism disorder.

Key words: type 2 diabetes mellitus, insulin pump, intensive treatment, islet &beta, cells