CAJ | 학술논문

目的：观察2型糖尿病合并支气管哮喘患者运用不同剂型糖皮质激素治疗后，对患者胰岛素敏感性和胰岛β细胞功能的影响情况。方法选择2009年1月至2012年1月枣庄市山亭区人民医院收治的，同时符合2型糖尿病诊断标准和支气管哮喘(慢性持续期)诊断标准的患者86例，随机分为两组，A 组采用吸入性糖皮质激素治疗，B 组采用口服糖皮质激素治疗。3个月后行口服葡萄糖耐量试验（OGTT）及胰岛素释放试验，计算稳态模型胰岛β细胞功能指标（HOMA-β）和胰岛素抵抗指数（HOMA-IR）。结果A 组患者治疗前后胰岛素敏感性和胰岛β细胞功能无明显差异（P>0.05），B 组患者治疗前较治疗后胰岛素敏感性降低（P<0.05），胰岛β细胞功能下降（P<0.05）。结论选用吸入性糖皮质激素治疗合并糖尿病的支气管哮喘患者，胰岛素敏感性和胰岛β细胞功能无明显影响；口服强的松10 mg 治疗3个月，对患者胰岛素敏感性和胰岛β细胞功能有明显不良影响。
목적：관찰2형당뇨병합병지기관효천환자운용불동제형당피질격소치료후，대환자이도소민감성화이도β세포공능적영향정황。방법선택2009년1월지2012년1월조장시산정구인민의원수치적，동시부합2형당뇨병진단표준화지기관효천(만성지속기)진단표준적환자86례，수궤분위량조，A 조채용흡입성당피질격소치료，B 조채용구복당피질격소치료。3개월후행구복포도당내량시험（OGTT）급이도소석방시험，계산은태모형이도β세포공능지표（HOMA-β）화이도소저항지수（HOMA-IR）。결과A 조환자치료전후이도소민감성화이도β세포공능무명현차이（P>0.05），B 조환자치료전교치료후이도소민감성강저（P<0.05），이도β세포공능하강（P<0.05）。결론선용흡입성당피질격소치료합병당뇨병적지기관효천환자，이도소민감성화이도β세포공능무명현영향；구복강적송10 mg 치료3개월，대환자이도소민감성화이도β세포공능유명현불량영향。
Objective To observe the effect on the function of pancreatic islet β cells and sensitivity to insulin when treating patients suffering from bronchial asthma and diabetes with different forms of glucocorticoids. Methods 86 cases conforming with diagnosis criteria of diabetes and bronchial asthma were randomly divided into 2 groups. Patients in group A were treated with inhaled glucocorticoid while cases in group B took oral glucocorticoid. Oral glucose tolerance test and insulin release test were performed after three months. HOMA-βand HOMA-IR of steady model were calculated. Results The function of pancreatic islet β cells and the sensitivity to insulin of patients in group A had no significant difference before and after therapy(P>0.05). The function of pancreatic islet β cells and the sensitivity to insulin of patients in group B descended significantly after therapy (P<0.05). Conclusion There were no obvious influences on the function of pancreatic islet β cells and sensitivity to insulin of patients suffering from bronchial asthma and diabetes when treated with inhaled glucocorticoid. While there were obvious adverse effects when treated with oral 10 mg prednisone per day for 3 months.