摘要
【目的】探讨双时相门冬胰岛素50（BIAsp50）与双时相人胰岛素50（BH150）治疗2型糖尿病（T2DM）的疗效及其对患者餐后2h血糖（2hPG）、血清可溶性细胞间黏附因子（siCAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1）、单核细胞趋化蛋白-1（MCP-1）与肿瘤坏死因子-α（TNF-α）水平的影响。【方法】选取2016年1月至2017年1月本院收治的既往未行胰岛素治疗的66例T2DM患者为研究对象，随机分为BIAsp50组与BH150组各33例。分别给予BIAsp50、BHl50每日两次皮下注射。比较两组治疗前后的空腹血糖（FPG）、2hPG及增幅、餐后2h内的增幅曲线下面积（IAUC）及糖化血红蛋白（HbAlc），以及血清siCAM-1、sVCAM-1、MCP-1和TNF-α等炎症指标的水平。【结果】①治疗前，两组血糖水平各指标（FPG、2hPG、2hPG的振幅、IAUC及HbA1c）比较，差异均无统计学意义（P〉0．05）。治疗后6、12周，两组各个血糖指标均显著降低（P〈0．05）；BIAsp50组治疗后6、12周的2hPG、2hPG的增幅、2h内的IAUC均显著低于BH150组；治疗后12周的HbA1c显著低于BH150组，差异均有统计学意义（P〈0．05）。②BIAsp50组低血糖事件的总发生率为12．1％，显著低于BH150组的33．3％，差异均有统计学意义（P〈0．05）。③治疗前，两组各炎症指标比较，差异均无统计学意义（P〉0．05）。治疗后6、12周，两组的各个炎症指标均显著降低（P〈0．05）；组间比较，BIAsp50组治疗后12周的各炎症指标均显著低于BH150组，治疗后6周的sVCAM-1、TNF-α显著低于BH150组，差异均有统计学意义（P〈0．05）。【结论】与BH150相比，BIAsp50对T2DM患者具有更好的餐后血糖控制效果，低血糖事件的发生率更低，且治疗后的siCAM-1、5VCAM-1、MCP-1和TNF-α水平更低，对血管内皮细胞损伤与炎症反应的改善效果更加突出。
[Objective]To study the effect of biphasic insulin aspart 50 （BIAsp50） and biphasic human insulin 50 （BHI50） in type 2 diabetes mellitus （T2DM） and on 2h postprandial plasma glucose （2hPG）, serum levels of soluble intercellular adhesion molecule-1 （sICAM-1）, soluble vascular cell adhesion molecule （sVCAM-1）, mono- cyte chemoattractant protein-1 （MCP-1） and tumor necrosis factor-a （TNF-α）.[Methods]66 patients with T2DM without previous insulin treatment in our hospital from January 2016 to January 2017 were enrolled the study and randomly divided into BIAsp50 group and BHIS0 group, 33 cases in each group. Patients in the two groups were given BIAsp50 and BHIsp50 through subcutaneous injection twice daily. Fasting plasma glucose （FPG）, 2hPG and its increment, incremental area under curve （IAUC） within postprandial 2h, serum levels of inflammatory mark- ers including slCAM-1, sVCAM-1, MCP-1 and TNF-α were compared between the two groups before and after treatment.[Results]（1）There were no significant differences in baseline data, plamsa glucose level and inflammation markers between the two groups before treatment （ P 〉0.05）. （2） At 6 and 12 weeks after treatment, plasma glu- cose level were significantly decreased in the two groups （ P 〈 0.05）.There was no significant difference in FPG between the two groups after treatment （ P〉0.05）. 2hPG and its increment, IAUC within postprandial 2h in the BIAsp50 group at 6 and 12 weeks after treatment were significantly lower than those in BHIS0 group, and HbAlc at 12 weeks after treatment was significantly lower than that in the BHIS0 group （ P 〈0.05）. （3）The total inci- dence of hypoglycemia in the BIAsp50 group was 12.1% and significantly lower than in the BHI50 group 33.3 % （ P 〈0.05）, but there were no significant differences in incidences of each type of hypoglycemia between the two groups （ P 〉 0.05）. （4）At 6 and 12 weeks after treatment, serum levels of inflammatory markers we
作者
付冬霞
郭宁宁
苏娜
许金秀
王光亚
FU Dong-xia , GUO Ning-ning , SU Na ,et al(The 2nd Department of Endocrinology, Cangzhou Central Hospital ,Cangzhou, Hebei Province, 06100)
出处
《医学临床研究》
CAS
2018年第3期459-463,共5页
Journal of Clinical Research
