摘要
目的:观察1型糖尿病(T1DM)患儿行早期胰岛素(INS)持续静脉输注加三餐前皮下注射短效INS强化治疗对胰岛b细胞功能的影响。方法:T1DM并酮症酸中毒(DKA)患儿12例(强化组),采用早期INS持续输注加三餐前皮下注射短效INS强化治疗,连续观察治疗开始及治疗3个月时空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、空腹C肽/FBG(C-P/FBG)及INS用量,比较治疗前后上述指标的差异,T1DM并DKA患儿10例(非强化组),行非持续静脉强化治疗,对比两组治疗开始及治疗3个月时上述指标的差异;观察急性期患儿进入蜜月期的百分率。结果:①治疗3个月时,强化组FBG、2hPBG及HbA1c均较治疗开始时显著改善,且均达到强化治疗目标;C-P/FBG显著升高,达正常范围;3个月时INS用量显著低于急性期;②非强化组FBG、2hPBG、HbA1c均较开始治疗时明显改善,但未达到强化治疗目标;C-P/FBG升高,但未达正常范围;INS用量无明显减少;③两组治疗开始FBG、2hPBG、HbA1c、C-P/FBG比较差异均无统计学意义,但INS用量强化组显著高于非强化组;治疗3个月时强化组2hPBG、HbA1c、INS用量均显著低于非强化组,C-P/FBG显著高于非强化组(约是后者的8.6倍),两者FBG比较差异无统计学意义;④强化组12例中11例进入蜜月期,非强化组仅3例进入蜜月期。两组比较c2=6.50,P<0.05。结论:早期INS持续输注加三餐前皮下注射短效INS强化治疗儿童T1DM可促进β细胞的修复及再生,使基础C-P/FBG恢复正常。
Objective ：To study the effect of early intensive treatment with insulin continuous intravenous infusion plus three bolus preprandial subcutaneous injection on βcell function of islets in children with type 1 diabetes mellitus（T1DM）. Methods： Fasting blood glucose （FBG）, 2-hour postprandial blood glucose（2hPBG）, glycosylated-haemoglobin （HbAlc）, C-peptide/FBG and insulin dosage were continuously observed respectively in intensive group in twelve patients and compared with results from ten patients with T1DM complicated by DKA in the non-intensive therapeutic group at the beginning and the end of the third therapeutic month. Numbers of patients from acute period entering honeymoon period were observed. Results：FBG, 2-hPBG and HbAlc had significant differences at the end of the third therapeutic month to those at the beginning in intensive therapeutic group and non-intensive therapeutic group, whereas the former attained the target of intensive therapy. C-P/FBG was significantly increased at the end of the third therapeutic month than at the beginning in two groups, but the latter did not reach the normal range. Besides significantly lower of INS dosage at the end of the third therapeutic month than at the beginning in intensive therapeu- tic group, there was no significant differences in non-intensive therapeutic group, whereas 2-hPBG and HbAlc and INS dosage were significantly lower and C-P/FBG was significantly higher in intensive therapeutic group than in non-intensive therapeutic group at the end of the third therapeutic month. Eleven patients entered honeymoon period in intensive therapeutic group, but only three in non-intensive therapeutic group （χ2=6.50,P〈0.05）. Conclusions： Early intensive treatment with insulin continuous intravenous infusion plus three bolus preprandial subcutaneous injection in children with newly diagnosed T1DM can promote regeneration of islet B cell and restore the normal function of basal C-P/FBG.
出处
《山东大学学报（医学版）》
CAS
北大核心
2006年第2期193-195,204,共4页
Journal of Shandong University:Health Sciences
关键词
糖尿病
1型
胰岛素
胰岛
儿童
Diabetes mellitus, type 1
Insulin
Islets of langerhans
Child
