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目的探讨新诊断T2DM患者胰岛素强化治疗前后肾上腺皮质及交感—肾上腺髓质功能的变化及意义。方法纳入新诊断T2DM患者30例,予胰岛素强化治疗,测定治疗前后FPG、2 hPG、FC-P、2 hC-P,24 h尿游离皮质醇(UFC)、尿甲氧基去甲肾上腺素(UNM)、尿甲氧基肾上腺素(UMN)水平,计算胰岛β细胞功能指数(△C—P/△PG)。结果治疗后FPG、2 hPG、24 hUFC、NM下降;△C—P/△PG上升(P<0.05)。结论新诊断T2DM患者胰岛素强化治疗后不仅能抑制高血糖状态下过兴奋的HPA轴,并可能通过降低去甲肾上腺素水平抑制交感机能的亢进。
Objective To investigate the changes of adrenocortical and sympathetic-adrenal medulla functions in patients with newly diagnosed T2DM before and after insulin intensive treatment. Methods Thirty new patients diagnosed with T2DM were enrolled in this study. Patients were given insulin intensive therapy before and after treatment. The levels of FPG, 2 hPG, FC-P, 2 hC-P, 24 h urinary free cortisol (UFC), urinary methy norepinephrine UNM) and urinary methoxypyridazine (UMN). The function index of islet β cell (△ C-P / △ PG) was calculated. Results After treatment, FPG, 2 hPG, 24 hUFC, NM decreased; △ C-P / △ PG increased (P <0.05). Conclusions Insulin fortification in newly diagnosed T2DM patients not only inhibits the over-excited HPA axis under hyperglycemia, but also inhibits the hyperactivity of sympathetic viability by decreasing norepinephrine level.