短期胰岛素泵强化治疗对初诊2型糖尿病患者循环内皮祖细胞水平的影响及意义

【目的】探讨短期持续皮下输注胰岛素（CSII）强化治疗对初诊2型糖尿病患者循环内皮祖细胞（EPCs）水平的影响及CSII治疗保护血管的可能机制。【方法】采用密度梯度离心法收集外周血单个核细胞,诱导分化培养7天后,激光共聚焦显微镜鉴定FITC—UEA和DiLacLDL双染色阳性细胞为正在分化的EPCs,并在倒置显微镜下计数。40例初诊2型糖尿病患者接受为期2周的CSII强化治疗,于治疗前、后采用上述方法分别计数EPCS,同时测空腹血糖（FBS）,餐后2小时血糖（PBS）和糖化血红蛋白（HbAlC）。【结果】2型糖尿病患者外周血循环EPCs较正常对照组明显减少,与HbAlC呈负相关,经CSII治疗后循环EPCS明显增加。【结论】初诊2型糖尿病患者外周血EPCs数量减少,早期CSII强化治疗不仅能迅速纠正糖代谢紊乱,同时能增加外周血EPCs数量,预防和延缓血管病变的发生。

Influence of Short-term Intensive Treatment with Insulin Pump on the Level of Circulating Endothelial Progenitor Cells of Patients of Newly Diagnosed Type 2 Diabetes and Its Significance

[Objective] To observe the effect of short-term continuous subcutaneous insulin infusion （CSII） therapy on the level of peripheral blood circulating endothelial progenitor eells（EPCs） of patients with newly diagnosed type 2 diabetes （T2DM） and to explore the mechanism of vascular protection of CSII therapy. [Methods] Density gradient centrifugation was used to collect peripheral blood mononuclear cells. After induced differentiation for 7 days, FITC-UEA and double staining DIL acLDL positive cells identified by laser scanning confoeal microscope were differentiated EPCs, and were counted under inverted microscope. Forty cases of newly diagnosed T2DM received CSII therapy for two weeks. Before and after the treatment, EPCs were counted, and fasting plasma glucose （FBS）, 2-hour postprandial blood glucose （PBS） and glycosylated hemoglobin （HbA1C） were tested. [Results] The EPCs in peripheral blood of patients with T2DM signifi- cantly reduced. Correlation analysis found that EPCS were negatively correlated with HbA1C. After shortterm CSII therapy, EPCs in patients with T2DM increased. [Conclusion] EPCs in patients with newly diag nosed T2DM have been clearly reduced. Early CSII therapy can not only quickly correct the disordered glucose metabolism, but also can increase the number of EPCs in peripheral blood and prevent the occurrence of vascu lar disease.