CAJ | 학술논문

【目的】研究短期持续皮下胰岛素泵输注（CSⅡ）对新诊2型糖尿病（T2DM ）不用其他药物的前提下能否长期控制血糖，以及潜在的作用机制。【方法】对新诊 T2DM 患者[ n ＝126，空腹血糖（FBG）＞13．9 mmol/L]入院接受2周的CSII治疗。在CSII前后，进行静脉糖耐量试验（IVGTT）测定血糖、糖化血红蛋白（HbA1c）、脂质谱、血浆游离脂肪酸（FFA ）、前胰岛素和C肽水平。随访期间患者停用胰岛素，仅进行长期饮食控制。【结果】126例患者在接受CSII的第（6．3±3．9）d达到最佳血糖控制[空腹血糖（FBG）＜6．1 mmol/L ，餐后2 h血糖（2hPG）＜8．0 mmol/L]。完成CSII二周治疗后与治疗前比较，患者FPG ，2hPG ，HBA1C及总胆固醇（TC），三酰甘油（TG），低密度脂蛋白胆固醇（LDL-C）、FFA均较治疗前显著下降，高密度脂蛋白胆固醇（HDL-C）明显上升（ P ＜0．01，P ＜0．05），β细胞功能恢复程度更大（ P＜0．05）。【结论】短期强化胰岛素疗法可使具有严重高血糖的新诊T2DM患者血糖得到长期控制。β细胞功能改善，尤其是第一时相胰岛素分泌的恢复，可能是患者获得缓解的机制。
【목적】연구단기지속피하이도소빙수주（CSⅡ）대신진2형당뇨병（T2DM ）불용기타약물적전제하능부장기공제혈당，이급잠재적작용궤제。【방법】대신진 T2DM 환자[ n ＝126，공복혈당（FBG）＞13．9 mmol/L]입원접수2주적CSII치료。재CSII전후，진행정맥당내량시험（IVGTT）측정혈당、당화혈홍단백（HbA1c）、지질보、혈장유리지방산（FFA ）、전이도소화C태수평。수방기간환자정용이도소，부진행장기음식공제。【결과】126례환자재접수CSII적제（6．3±3．9）d체도최가혈당공제[공복혈당（FBG）＜6．1 mmol/L ，찬후2 h혈당（2hPG）＜8．0 mmol/L]。완성CSII이주치료후여치료전비교，환자FPG ，2hPG ，HBA1C급총담고순（TC），삼선감유（TG），저밀도지단백담고순（LDL-C）、FFA균교치료전현저하강，고밀도지단백담고순（HDL-C）명현상승（ P ＜0．01，P ＜0．05），β세포공능회복정도경대（ P＜0．05）。【결론】단기강화이도소요법가사구유엄중고혈당적신진T2DM환자혈당득도장기공제。β세포공능개선，우기시제일시상이도소분비적회복，가능시환자획득완해적궤제。
[Objective]To explore the efficacy and potential action mechanism of short-term continuous subcutaneous insulin infusion pump(CSII) for long-term control of blood glucose in the premise of no other drugs .[Methods] Patients with newly diagnosed type 2 diabetes mellitus(T2DM)[ n=126 ,fasting blood glucose(FBG)>13 .9mmol/L] received 2 weeks of CSII treatment on admission .Intravenous glucose tolerance test (IVGTT ) before and after CSII was taken to measure blood glucose ,glycosylated hemoglobin(HbA1c) ,lipid profile ,proinsulin and C-peptide .During the follow-up , patients stopped using insulin ,but only received long-term diet control .[Results]The 126 patients achieved optimal glu-cose control(FBG<6 .1mmol/L ,2hPG<8mmol/L) on (6 .3 ± 3 .9)d after CSII .Compared with before treatment ,FPG , 2hPG ,HbA1c ,TC ,TG ,LDL-C and FFA of patients 2 weeks after CSII were markedly decreased ,but HDL-C was ob-viously increased( P < 0 .01 ,P < 0 .05) ,and the recovery of beta cell function was more significant ( P < 0 .05) .[Conclusion]Short-term intensive insulin therapy can achieve long-term control of blood sugar in newly diagnosed T2DM patients with severe hyperglycemia ,and improve beta cell function ,and especially recover the first phase insulin secretion , which may be the mechanism of the alleviation of patients .