短期胰岛素强化治疗对磺脲类继发性失效患者β细胞功能的影响.docVIP

精品论文 参考文献 短期胰岛素强化治疗对磺脲类继发性失效患者β细胞功能的影响 郑欣 闵好 （湖北省荆州市三医院内分泌科 434001） 【中图分类号】R969【文献标识码】A【文章编号】1672-5085（2012）13-0079-03 【摘要】目的 主要探讨短期胰岛素强化治疗对2型糖尿病磺脲类继发失效患者beta;细胞分泌功能的影响。方法 2型糖尿病磺脲类继发失效患者31例。停用原口服药后予以胰岛素强化治疗，疗程2周。通过检测治疗前后糖代谢参数，计算beta;细胞分泌功能和胰岛素抵抗状况等。结果 胰岛素强化治疗后血糖达标时间为4.4plusmn;2.1d，胰岛素剂量平均为48.6plusmn;19.2u.d-1，未出现显著不良反应。与治疗前比较，治疗后beta;细胞分泌功能和胰岛素抵抗均显著改善（plt;0.01）。结论 短期胰岛素强化治疗，可改善2型糖尿病磺脲类继发性失效患者的beta;细胞分泌功能和胰岛素抵抗。 【关键词】2型糖尿病 磺脲类药物 胰岛素 继发性失效 Effects of short-term intensive insulin therapy on beta;cell secretion function in patients with secondary failure of sulfonylurea Zheng Xin Min Hao Third Hospital of Jingzhou, Jingzhou, 434001 Hubei province, China) 【Abstract】 To evaluate the effect of short-term intensive insulin therapy on beta;-cell secretion function and insulin resistance in patients with T2DM secondary failure of sulfonylurea. Methods: 31 patients with T2DM secondary failure of sulfonylurea were enrolled. All oral anti－diabetic agents were discontinued, intensive insulin regimens were given by insulin pump or multiple subcutaneous infusion for 2 weeks. Beta-cell secretion function and insulin resistance were evaluated by OGTT and insulin releases test before and after the treatment. Results: After the treatment, blood-glucose control average times was 4.14plusmn;2.1d,and insulin average dose was 48.6plusmn;19.2ubull;d-1. Adverse reactions were slight. Compared to before The treatment, there were significant improvement in beta-cell secretion function and insulin resistance status(Plt;0.01). Conclusion： The results of this study confirm that short-term intensive insulin therapy can improve Beta-cell secretion function and insulin resistance in patients with T2DM secondary failure of sulfonylurea. 【Key words】T2DM sulfonylurea insulin secondary failure 磺脲类药物继发性失效（secondary failure of sulfonylurea, SFS），是2型糖尿病(T2DM)治疗中的一个常见问题，其机制尚不十分清楚。但多认为与beta;细胞功能异常有关[1]。近年研究证实[2，3]，对T2DM，即使是新发病者，予以胰岛素(Ins)强化治疗，可保护和恢复beta;细胞功能。为此，我们对SFS施行短期Ins强化治疗，比