新诊断严重高血糖2型糖尿病患者胰岛素治疗前后炎症递质变化.doc

新诊断严重高血糖2型糖尿病患者胰岛素治疗前后炎症递质变化 　 作者：陈咨苗，章圣辉，陈肖俊，章惺惺，吴文俊，倪连松 【摘要】 目的 ：观察严重高血糖2型糖尿病患者经胰岛素强化治疗前后炎症递质的变化情况，探讨高血糖与炎症的关系以及胰岛素的抗炎症作用。方法：入选20例空腹血糖(FBG)高于15 mmol/L或随机血糖大于30 mmol/L的2型糖尿病患者(严重高血糖组)，进行胰岛素强化治疗，检测治疗前后血清脂联素(ANP)、IL-6、TNF-α水平，另选取血糖控制较好的一般糖尿病患者(空腹血糖≤7.0 mmol/L或餐后血糖≤10 mmol/L)(一般糖尿病组)及正常的健康人群各20例为对照组，比较三组治疗前的实验指标、严重高血糖组治疗前后实验结果，并比较严重高血糖组治疗后与一般糖尿病组及健康对照组的指标差异。结果：严重高血糖组ANP水平较一般糖尿病组高，IL-6、TNF-α水平健康对照组明显升高。严重高血糖组经胰岛素强化治疗后ANP水平升高接近于正常水平，而IL-6、TNF-α水平则有所下降，但未达到正常水平。结论：短期强化胰岛素治疗能快速改善2型糖尿病严重高血糖的炎症状态。 【关键词】 糖尿病，2型;胰岛素;治疗;炎症递质 　Abstract: Objective: To reveal the relationship between hyperglycosemia，inflammation　mediators and the anti-inflammatory effect of insulin intensive therapy in patients with newly　　diagnosed type 2 diabetes and severe hyperglycosemia. Methods: Twenty newly diagnosed type 2　　diabetes patients with fasting plasma glucose (FPG) more than 15 mmol/L or random blood sugar　　(RBS)more than 30 mmol/L were treated with insuline intensive therapy(several hyperglycemia　　group). Their serum adiponectin，IL-6 and TNF-α were quantitatively measured at pre-andpost-insulin treatment. Twenty common diabetic patients with well-controlled blood glucose(fasting plasma glucose≤7.0 mmol/L or past plasma glucose≤10 mmol/L)(general diabetes group)and 20 health patients (healty control group) were selected as control groups. Results: Theserum level of adiponectin in several hyperlycemia group patients was higher than that of generaldiabetes group， while the levels of IL-6 and TNF-α in this group were obviously higher than thatin healty control group. After insuline intensive therapy of several hyperlycemia group，the serumlevel of adiponectin increased to nearly normal level， while the levels of IL-6 and TNF-αdecreased but still at abnormal level. Conclusion: Short-term insuline intensive therapy canquickly improve the inflam-mation state of newly diagnosed type 2 diabetes patients with severehyperglycosemia. 　　Key words: diabetes，type 2;insuline;therapy;mediators of in