实时胰岛素泵治疗对2型糖尿病患者氧化应激及血管内皮功能的影响

［摘要］ 目的探讨实时胰岛素泵治疗对2型糖尿病患者8-异前列腺素F2α（8-iso-PGF2α）及非对称性二甲基精氨酸(asymmetricdimethylarginine，ADMA)水平的影响。 方法筛选60例2 型糖尿病患者随机分为2组，试验组应用722胰岛素泵（3C）治疗，对照组采用每日多次胰岛素皮下注射治疗。2组均佩戴实时动态血糖监测系统（real-time dynamic glucose monitoring system，CGMS）即美敦力公司生产的722泵。比较2组血糖标准差（standard deviation of blood glucose，SDBG）、平均血糖波动幅度（mean amplitude of glycaemic excursion，MAGE）、最大血糖搏动幅度（last amplitude of glycaemic excursion，LAGE ）、低血糖发生率、血清8-iso-PGF2α及ADMA水平，同时进行相关性分析。 结果2组治疗后SDBG、MAGE、LAGE均较治疗前下降，试验组较对照组下降更明显（P＜0.05）。试验组低血糖发生率明显少于对照组（P＜0.05）。2组治疗后8-iso-PGF2α、ADMA均较治疗前下降，试验组较对照组下降更明显（P＜0.05）。试验组治疗前后MAGE与8-iso-PGF2α、ADMA均呈正相关（P＜0.05）。 结论实时动态胰岛素泵治疗能够较好控制2型糖尿病患者的血糖波动，且不增加低血糖发生的风险，可能通过减轻氧化应激、改善血管内皮功能而减少血糖波动，最终有效控制血糖。

Effects of real-time insulin pump on oxidative stress and vascular endothelial function in patients with type 2 diabetes mellitus#br#

［Abstract］ Objective〖HTSS〗To investigate the effect of real-time insulin pump therapy on the levels of 8-iso-PGF2α and asymmetric dimethylarginine in patients with type 2 diabetes mellitus. 〖WTHZ〗Methods〖HTSS〗Sixty patients with type 2 diabetes were enrolled and randomly divided into two groups. The experimental group received 722 insulin pump(CSII+ rt-cgms +Carelink), and the control group received multiple subcutaneous injection of insulin and daily. All patients in both groups wore a 722 pump manufactured for medtronic by the real-time dynamic blood glucose monitoring system(rt-cgms). Blood glucose standard deviation(SDBG), mean amplitude of glycaemic excursion(MAGE) the last amplitude of glycaemic excursion(LAGE), incidence of hypoglycemia, serum 8-iso-PGF2α level and ADMA level were compared between two groups before and after treatment. 〖WTHZ〗Results〖HTSS〗SDBG, MAGE and LAGE were significantly decreased before and after treatment, and the decrease was more obvious in the experimental group than those in the control group(P＜0.05). The incidence of hypoglycemia in the experimental group was significantly lower than that in the control group(P＜0.05). Compared with before treatment, 8-iso-PGF2α and ADMA decreased in the experimental group and the control group after treatment, while the difference was more significant in the experimental group(P＜0.05). In the experimental group before and after treatment 8-iso-PGF2α and ADMA were positively related(P＜0.05). 〖WTHZ〗Conclusion〖HTSS〗Real-time dynamic insulin pump therapy can better control the blood glucose fluctuation in patients with type 2 diabetes mellitus without increasing the risk of hypoglycemia. It may reduce the blood glucose fluctuation and ultimately effectively control blood glucose by reducing oxidative stress and improving vascular endothelial function.