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目的比较2型糖尿病(T2DM)合并胫前皮肤黑斑与胫前皮肤无黑斑患者胰岛素曲线下面积(AUC)的不同,为临床个体化诊断和治疗糖尿病胫前黑斑提供科学的理论依据。方法收集2004年6月至2006年1月在天津医科大学总医院住院的242例T2DM患者为研究对象,根据有无黑斑分为胫前皮肤有黑斑组和无黑斑组。其中有黑斑组106例,男性58例,女性48例,年龄29~76岁,平均(47.3±16.0)岁,病程为1个月~20年。无黑斑组136例,男性75例,女性61例,年龄31~78岁,平均(48.5±15.0)岁,病程为1个月~21年。行口服葡萄糖耐量及胰岛素刺激试验,并进行血糖AUC和胰岛素AUC比较。结果有黑斑组血糖AUC为(28.12±4.21)mmol·h/L,高于胫前无黑班组[(26.72±5.15)mmol·h/L],差异有统计学意义(P<0.05)。有黑斑组胰岛素AUC为(41.71±8.01)μIU·h/ml,低于无黑斑组[(45.01±8.91)μIU·h/ml],差异有统计学意义(P<0.05)。结论应对胫前皮肤有黑斑的T2DM患者及时给予胰岛素治疗,延缓其并发症的发生与发展。
Objective To compare the area under the curve of insulin (AUC) between patients with type 2 diabetes mellitus (T2DM) presenting anterior skin black spots and anterior tibial skin without melasma, and to provide a scientific basis for clinical individualized diagnosis and treatment of diabetic anterior tibia. Methods Totally 242 T2DM patients hospitalized in Tianjin Medical University General Hospital from June 2004 to January 2006 were selected as study subjects. According to the presence or absence of dark spots, there were black spot group and non-black spot group. There are 106 cases of black spot group, 58 males and 48 females, aged 29 to 76 years, with an average of (47.3 ± 16.0) years old, duration of 1 month to 20 years. There were 136 cases without melasma, 75 males and 61 females, ranging in age from 31 to 78 years with an average of (48.5 ± 15.0) years and had a course of 1 month to 21 years. Oral glucose tolerance and insulin stimulation test, and blood glucose AUC and insulin AUC comparison. Results The blood glucose AUC in sham group was (28.12 ± 4.21) mmol · h / L, which was significantly higher than that in sham operation group [(26.72 ± 5.15) mmol · h / L] (P <0.05). There was a significant difference between the two groups (P <0.05). The AUC of insomnia in the sham group was (41.71 ± 8.01) μIU · h / ml, which was lower than that in the group without the scars [(45.01 ± 8.91) μIU · h / ml] Conclusion The treatment of T2DM patients with anterior tibial skin with dark spots should be promptly given insulin therapy to delay the occurrence and development of its complications.