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目的探讨初诊断2型糖尿病(type2 diabetes mellitus,T2DM)胰岛素强化治疗缓解的临床因素。方法收集作者医院2013-10/2015-02月收治的初诊断T2DM168例临床资料,胰岛素强化治疗后分为临床缓解组和未缓解组,比较2组临床特征,分析临床缓解相关因素。结果治疗前缓解组体质量指数(body mass index,BMI)、三酰甘油(triglyceride,TG)、空腹C肽(fasting C peptide,FCP)、脂肪肝合并率高于未缓解组(P<0.05);诊断时年龄、餐后2h血糖(2 hour postprandial blood glucose,2hPG)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、冠心病合并率明显低于未缓解组(P<0.05)。空腹血糖(fasting blood glucose,FPG)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、尿微量白蛋白(urinary microalbuminuria,UMA)、吸烟率、糖尿病家族史、酮症并发率及干预措施(初治胰岛素、二甲双胍、阿卡波糖、ACEI/ARB、他汀类使用量)相似,两组无统计学差异(P>0.05)。多因素分析结果显示,发病年龄小、高BMI、高TG、高FCP、合并脂肪肝为临床缓解的保护性因素。结论发病年龄小、高BMI、高TG、高FCP、合并脂肪肝,为初诊断T2DM患者胰岛素强化治疗后临床缓解有利因素。
Objective To investigate the clinical factors of remission of type 2 diabetes mellitus (T2DM). Methods The clinical data of 8 cases of newly diagnosed T2DM admitted in the author hospital from October 2013 to February 2015 were collected and divided into clinical remission group and non-remission group after intensive insulin treatment. The clinical features of the two groups were compared and the related factors of clinical remission were analyzed. Results Before treatment, the body mass index (BMI), triglyceride (TG), fasting C peptide (FCP) and the rate of fatty liver in the remission group were higher than those in the non-remission group (P <0.05) ; The age at diagnosis, 2h postprandial blood glucose (2hPG), glycosylated hemoglobin A1c (HbA1c) and the rate of coronary heart disease were significantly lower than those of the non-remission group (P <0.05). Fasting blood glucose (FPG), systolic blood pressure (SBP), diastolic blood pressure (DBP), urinary microalbuminuria (UMA), smoking prevalence, family history of diabetes, ketosis There was no significant difference between the two groups (P> 0.05), and the incidence of complications and the intervention measures (initial treatment of insulin, metformin, acarbose, ACEI / ARB, statin use) were similar. Multivariate analysis showed that age of onset, high BMI, high TG, high FCP, combined with fatty liver as a protective factor in clinical remission. Conclusions The age of onset, high BMI, high TG, high FCP, and fatty liver are the favorable factors for clinical remission after intensive insulin therapy in newly diagnosed T2DM patients.