摘要
目的分析早期持续皮下胰岛素输注(CSII)治疗对初诊2型糖尿病(T2DM)患者胰岛β细胞功能的影响。方法选取2020年6月~2021年12月就诊于潍坊市人民医院内分泌科,新诊断为T2DM的患者共计237例为研究对象,随机分为胰岛素泵组(CSII组)、长效胰岛素联合口服药物组(OHA组)和单纯口服药物组(ABI组),3组患者分别采用不同的降糖方案治疗,并分析其临床指标的差异。结果经治疗,各组间患者的空腹血糖(FPG)、治疗前后空腹血糖差(ΔFPG)、餐后2h血糖(2h PG)、治疗前后2h血糖差(Δ2h PG)、血糖达标率、血糖达标时间均存在差异,CSII组优于另外两组,差异有统计学意义(P<0.05);各组间患者的空腹C肽(FCP)、β细胞分泌指数(HOMA2-%B)均存在差异,CSII组高于另外两组,差异有统计学意义(P<0.05)。相关性分析显示,HOMA2-%B与年龄、收缩压(SBP)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、尿微量白蛋白/尿肌酐(UACR)、治疗后FPG、治疗后2h PG呈负相关;与25-羟维生素D_(3)(25-OH-D_(3))、FCP、2h C肽(2h CP)呈正相关。多元线性回归的逐步分析显示,25-OH-D_(3)、LDL-C、治疗后FPG为HOMA2-%B的独立影响因素。结论对于初诊T2DM的患者早期进行CSII短期强化治疗可在一定程度上保护胰岛β细胞的功能,减缓胰岛β细胞的损伤;25-OH-D_(3)与LDL-C为胰岛β细胞功能的重要影响因素。
Objective To analyze the effect of early Continuous Subcutaneous Insulin Infusion(CSII)treatment on isletβ-cell function in newly diagnosed type 2 diabetic patients.Methods A total of 237 patients with type 2 diabetes mellitus were selected from the Department of Endocrinology,Weifang People's Hospital from June 2020 to December 2021.Patients were randomly assigned to insulin pump group(CSII group),basal insulin combined with oral drug group(OHA group)and oral drug group(ABI group),and the differences of clinical indexes among the three groups were analyzed.Results After treated three groups with different schemes,there were differences in FPG,ΔFPG,2h PG,Δ2h PG,blood glucose attainment rate and blood glucose attainment time among the groups,CSII group was superior to the other two groups,the difference was statistically significant.There were differences in FCP and HOMA2-%B among the groups,and the indices of CSII group were higher compared with the other two groups,the difference was statistically significant(P<0.05).Correlation analysis showed that HOMA2-%B was negatively correlated with age,SBP,HbA1c,LDL-C,UACR,post-treatment FPG and post-treatment 2h PG,but positively correlated with 25-OH-D_(3),FCP and 2h CP.Stepwise analysis of multiple linear regression showed that 25-OH-D_(3),LDL-C and post-treatment FPG were independent influencing factors of HOMA2-%B.Conclusion Short-term intensive CSII therapy in patients with newly diagnosed type 2 diabetes can protect the function of isletβ-cells and slow down the damage of isletβ-cells to some extent.25-hydroxy vitamin D_(3) and low density lipoprotein cholesterol are important factors affecting isletβ-cell function.
作者
杨淼
刘长山
YANG Miao;LIU Changshan(Department of Endocrinology,Suzhou BenQ Medical Center,Suzhou 215000,China;Department of Endocrinology,Weifang People's Hospital)
出处
《潍坊医学院学报》
2023年第6期420-424,共5页
Acta Academiae Medicinae Weifang
