安徽医科大学学报
安徽醫科大學學報
안휘의과대학학보
ACTA UNIVERSITY MEDICINALIS ANHUI
2015年
4期
515-518
,共4页
章容%戴武%张继%王松%廖芳芳%叶军%曹永红%刘燕%汪运生%张苏皖%匡蕾%邹玲玲
章容%戴武%張繼%王鬆%廖芳芳%葉軍%曹永紅%劉燕%汪運生%張囌皖%劻蕾%鄒玲玲
장용%대무%장계%왕송%료방방%협군%조영홍%류연%왕운생%장소환%광뢰%추령령
磁共振波谱%2型糖尿病%胰岛素强化%海马
磁共振波譜%2型糖尿病%胰島素彊化%海馬
자공진파보%2형당뇨병%이도소강화%해마
magnetic resonance spectroscopy%type 2 diabetes mellitus%intensive insulin treatment%hippocampus
目的研究初诊2型糖尿病患者胰岛素强化治疗前后海马区N-乙酰天门冬氨酸复合物( NAA)/肌酸( Cr)、胆碱复合物( Cho)/Cr的变化。方法氢质子磁共振波谱(1 H-MRS)检测30例初诊2型糖尿病患者双侧海马区NAA/Cr、Cho/Cr,同时检测空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白( HbAlc)、三酰甘油( TG)、胆固醇( CHO)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、HOMA-β细胞功能指数( HOMA-β)和HOMA-胰岛素抵抗指数( HOMA-IR)。胰岛素泵强化降糖10~14 d,血糖达标后复查上述指标予以对比。结果胰岛素强化治疗后,患者 FPG、2 hPG、TG、CHO、LDL、HOMA-IR水平降低(P<0．05,P<0．01),HOMA-β水平升高( P <0．05)；左右侧海马区 NAA/Cr 升高( P <0．05),右侧海马区 Cho/Cr 降低( P <0．05),左侧海马区<br> Cho/Cr呈下降趋势,但差异无统计学意义；NAA/Cr、Cho/Cr与血糖、HOMA-β、HOMA-IR有一定相关性。结论胰岛素强化治疗初诊2型糖尿病,可改善患者血糖、血脂,同时可升高双侧海马区NAA/Cr、降低右侧海马区Cho/Cr,其机制可能与血糖降低、胰岛素分泌增加、胰岛素抵抗改善有关。
目的研究初診2型糖尿病患者胰島素彊化治療前後海馬區N-乙酰天門鼕氨痠複閤物( NAA)/肌痠( Cr)、膽堿複閤物( Cho)/Cr的變化。方法氫質子磁共振波譜(1 H-MRS)檢測30例初診2型糖尿病患者雙側海馬區NAA/Cr、Cho/Cr,同時檢測空腹血糖(FPG)、餐後2 h血糖(2 hPG)、糖化血紅蛋白( HbAlc)、三酰甘油( TG)、膽固醇( CHO)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、HOMA-β細胞功能指數( HOMA-β)和HOMA-胰島素牴抗指數( HOMA-IR)。胰島素泵彊化降糖10~14 d,血糖達標後複查上述指標予以對比。結果胰島素彊化治療後,患者 FPG、2 hPG、TG、CHO、LDL、HOMA-IR水平降低(P<0．05,P<0．01),HOMA-β水平升高( P <0．05)；左右側海馬區 NAA/Cr 升高( P <0．05),右側海馬區 Cho/Cr 降低( P <0．05),左側海馬區<br> Cho/Cr呈下降趨勢,但差異無統計學意義；NAA/Cr、Cho/Cr與血糖、HOMA-β、HOMA-IR有一定相關性。結論胰島素彊化治療初診2型糖尿病,可改善患者血糖、血脂,同時可升高雙側海馬區NAA/Cr、降低右側海馬區Cho/Cr,其機製可能與血糖降低、胰島素分泌增加、胰島素牴抗改善有關。
목적연구초진2형당뇨병환자이도소강화치료전후해마구N-을선천문동안산복합물( NAA)/기산( Cr)、담감복합물( Cho)/Cr적변화。방법경질자자공진파보(1 H-MRS)검측30례초진2형당뇨병환자쌍측해마구NAA/Cr、Cho/Cr,동시검측공복혈당(FPG)、찬후2 h혈당(2 hPG)、당화혈홍단백( HbAlc)、삼선감유( TG)、담고순( CHO)、저밀도지단백(LDL)、고밀도지단백(HDL)、HOMA-β세포공능지수( HOMA-β)화HOMA-이도소저항지수( HOMA-IR)。이도소빙강화강당10~14 d,혈당체표후복사상술지표여이대비。결과이도소강화치료후,환자 FPG、2 hPG、TG、CHO、LDL、HOMA-IR수평강저(P<0．05,P<0．01),HOMA-β수평승고( P <0．05)；좌우측해마구 NAA/Cr 승고( P <0．05),우측해마구 Cho/Cr 강저( P <0．05),좌측해마구<br> Cho/Cr정하강추세,단차이무통계학의의；NAA/Cr、Cho/Cr여혈당、HOMA-β、HOMA-IR유일정상관성。결론이도소강화치료초진2형당뇨병,가개선환자혈당、혈지,동시가승고쌍측해마구NAA/Cr、강저우측해마구Cho/Cr,기궤제가능여혈당강저、이도소분비증가、이도소저항개선유관。
Objective Changes in hippocampus N-acetyl aspartic acid compound (NAA)/creatine(Cr), choline compound ( Cho)/Cr before and after treatment of intensive insulin in patients with newly diagnosed type 2 diabetes mellitus. Methods Proton magnetic resonance spectroscopy (1H-MRS) was detected in 30 cases of newly diag-nosed type 2 diabetic patients with bilateral hippocampal NAA, Cho and Cr ratio, the simultaneous detection of FPG, 2 hPG, HbAlc, TG, CHO, LDL, HDL, HOMA-β and HOMA-IR. Treated with insulin pump intensive 10~ 14 days, the blood glucose level after the review index was compared. Results After intensive insulin therapy, patients with FPG, 2 hPG, TG, CHO, LDL, HOMA-IR decreased (P<0. 05,P<0. 01), HOMA-βincreased (P<0. 05 ); the left and right hippocampus NAA/Cr increased ( P <0. 05 ) , the right hippocampus Cho/Cr de-creased (P<0. 05), left hippocampus Cho/Cr area decreased, but no statistical difference. The relationship be-tween NAA/Cr, Cho/Cr and blood glucose, HOMA-β, HOMA-IR. Conclusion Intensive insulin therapy in new-ly diagnosed type 2 diabetes can improve blood glucose, blood lipids, and elevate NAA/Cr, bilateral hippocampus decreased Cho/Cr on the right side of the hippocampus, and its mechanism may be related to decrease of blood sug-ar, increase in insulin secretion,insulin resistance improvement.
