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目的探讨短期胰岛素强化治疗对新诊断T2DM患者相关指标的影响。方法采用多次皮下注射(MSII)和胰岛素泵持续皮下输注(CSII)方案对64例新诊断T2DM患者进行短期强化治疗,比较治疗前后FPG、2hPG、TC、TG、LDL-C、HDL-C、FFA、C-RP、精氨酸刺激试验、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)的变化。结果治疗达标后两组FPG、2hPG、TC、TG、LDL-C、FFA、C-RP、HOMA-IR均下降(P<0.05),HOMA-β、快速胰岛素分泌值(Ins2+4+6)增高(P<0.05),两组间差异无统计学意义(P>0.05);Pearson相关分析显示,HOMA-β、Ins2+4+6的升高与FPG、FFA下降呈正相关(P<0.05),多元逐步回归分析显示,BMI是影响HOMA-β、Ins2+4+6的独立相关因素(P=0.000)。结论短期胰岛素强化治疗可明显改善新诊断T2DM患者的胰岛β细胞功能,减轻IR,胰岛β细胞功能的改善与糖脂代谢的改善及体重密切相关。
Objective To investigate the effect of short-term insulin-intensive therapy on the newly diagnosed T2DM patients. Methods Sixty-four patients with newly diagnosed T2DM were treated with multiple subcutaneous injections (MSII) and insulin pump continuous subcutaneous infusion (CSII) for short-term intensive treatment. FPG, 2hPG, TC, TG, LDL-C and HDL- , FFA, C-RP, arginine stimulation test, insulin secretion index (HOMA-β) and insulin resistance index (HOMA-IR) Results After treatment, the levels of FPG, 2hPG, TC, TG, LDL-C, FFA, C-RP and HOMA-IR of the two groups were decreased (P < (P <0.05). There was no significant difference between the two groups (P> 0.05). Pearson correlation analysis showed that the increase of HOMA-βand Ins2 + 4 + 6 was positively correlated with the decrease of FPG and FFA (P < Multiple stepwise regression analysis showed that BMI was independently related to HOMA-β, Ins2 + 4 + 6 (P = 0.000). Conclusion Short-term intensive insulin treatment can significantly improve the newly diagnosed T2DM patients with pancreatic β-cell function, reduce IR, the improvement of pancreatic β-cell function and the improvement of glucose and lipid metabolism and body weight are closely related.