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方法:采用持续皮下胰岛素输注(CSII)前后对照并随访一年,观察48例口服降糖药(OHA)治疗失败的2-DM患者血糖控制达标时间,IVGTT、C肽、胰岛素(P)、胰岛素原(PI)以及PI/P比值,HomaB、HomaIR等变化,血糖检测的远期疗效以及对HbA1c、体重、血脂等代谢的影响。结果:不同时程CSII治疗血糖均能3~5天内达标,停止CSII后25%的病人需联合胰岛素补充治疗,15%的病人仍需依靠胰岛素治疗,60%的病人恢复OHA有效,CSII治疗前后对照及随访一年,部分病人胰岛素、C肽峰值、第一时相分泌尖峰,HomaB值均有提高,PI/P比值、HbA1c、血脂均有下降,以CSII28天时程更为明显。结论:对OHA失效的2-DM患者,短期CSII强化治疗具有快速稳定检测血糖和改善胰岛B细胞功能的作用。
Methods: The duration of glycemic control, IVGTT, C-peptide, insulin (P) and insulin resistance in 2-DM patients with failed oral hypoglycemic agents (OHA) were observed and compared for one year after continuous subcutaneous insulin infusion (CSII) (PI) and PI / P ratio, HomaB, HomaIR and other changes, long-term efficacy of blood glucose testing and HbA1c, body weight, blood lipids and other metabolic effects. Results: CSII treatment at different time points could reach the goal within 3 to 5 days. After CSII was stopped, 25% of the patients needed insulin replacement therapy. 15% of the patients still had to rely on insulin therapy and 60% of patients had OHA recovery. Before and after CSII treatment Control and follow-up of one year, some patients insulin, C peptide peak, first phase secretion peak, HomaB value increased, PI / P ratio, HbA1c, blood lipids decreased, with CSII28 days duration is more obvious. CONCLUSIONS: Short-term intensive CSII treatment in patients with 2-DM with OHA failure has the effect of rapid and stable detection of blood glucose and improvement of islet B cell function.