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目的探讨胰岛素泵(CSⅡ)短期强化治疗对初诊2型糖尿病(T2DM)患者血糖血脂代谢、胰岛β细胞功能及血清超敏C反应蛋白(hs-CRP)的影响。方法选取2014年9月至2015年8月于吉林省人民医院内分泌科初次诊断且接受CSⅡ短期强化治疗的63例T2DM患者作为研究对象,在控制饮食、运动疗法基础上采用CSⅡ进行治疗。治疗前和停止CSⅡ治疗后测定患者FBG、餐后2 h血糖(2 h PBG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、餐后1 h和2 h胰岛素(INS1、INS2)、胰岛β细胞分泌指数(Homa-IS)、胰岛素抵抗指数(HOMA-IR)及血清hs-CRP水平。结果 CSⅡ短期强化治疗2周后患者的FBG、2h PBG、TC、TG、LDL-C及hs-CRP水平均显著低于治疗前,HDL-C水平明显高于治疗前,差异均有统计学意义(均P<0.05);CSⅡ短期强化治疗2周后患者的FINS、INS1、INS2及Homa-IS均明显高于治疗前,HOMA-IR明显低于治疗前,差异均有统计学意义(均P<0.05)。结论 CSⅡ短期强化治疗能有效控制T2DM患者的血糖血脂代谢,改善胰岛β细胞功能,减轻胰岛素抵抗,降低血清hs-CRP水平,可作为初诊T2DM患者的主要治疗方法,有助于延缓糖尿病进展、减少并发症发生。
Objective To investigate the effects of insulin pump (CSⅡ) short-term intensive therapy on blood glucose and blood lipid metabolism, islet β-cell function and serum hs-CRP in newly diagnosed type 2 diabetes mellitus (T2DM) patients. Methods From September 2014 to August 2015, 63 patients with T2DM who were first diagnosed by Department of Endocrinology of People’s Hospital of Jilin Province and underwent CS Ⅱ short-term intensive therapy were enrolled in this study. They were treated with dietary and exercise therapy based on CSⅡ. The levels of FBG, 2 h PBG, TC, TG, HDL-C, LDL-C, The levels of insulin, insulin, INS-1, insulin-like growth factor (HOMA-IR) and serum hs- CRP level. Results The levels of FBG, 2h PBG, TC, TG, LDL-C and hs-CRP in patients treated with CSⅡ short-term intensive therapy for 2 weeks were significantly lower than those before treatment, and the levels of HDL-C were significantly higher than those before treatment (All P <0.05). FINS, INS1, INS2 and Homa-IS in patients with CSⅡ short-term intensive treatment for 2 weeks were significantly higher than those before treatment, HOMA-IR was significantly lower than before treatment <0.05). Conclusion CSⅡ short-term intensive treatment can effectively control blood glucose and lipid metabolism, improve pancreatic β-cell function, reduce insulin resistance and lower serum hs-CRP levels in T2DM patients. It can be used as a primary treatment for newly diagnosed T2DM patients, which can delay the progression of diabetes and reduce Complications occur.