胰岛素强化治疗对2型糖尿病下肢血管病变患者氧化应激水平的影响

目的探讨胰岛素强化治疗对2型糖尿病（T2DM）下肢血管病变氧化应激水平的影响。方法选择T2DM60例，根据踝臂指数（ABI）分为下肢血管病变组（LEAD组，n=28，ABI〈0．9）与无下肢血管病变组（NC组，n=32，ABI≥0．9），分别给予为期14d的胰岛素强化治疗，于治疗前后测定血清空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血清蛋白（GA）、同型半胱氨酸（Hey）、3-硝基酪氨酸（3-NT）、8-羟基脱氧鸟苷（8-OHdG），并对各指标进行分析比较。结果治疗前LEAD组Hcy、3-NT、8-OhdG水平显著高于NC组（P〈0．01）。胰岛素强化治疗后两组FPG、2hPG、GA较治疗前均有显著下降（P〈0．01），Hcy、3-NT、8．0hdG亦较治疗前显著下降（P〈0．05，P〈0．01），NC组下降得更明显。结论胰岛素强化治疗在降低血糖的同时改善机体氧化应激水平，但未合并下肢血管病变的T2DM患者的改善程度更优。

Effect of Intensive Insulin Therapy on the Level of Oxidative Stress in Patients with Type 2 Diabetic Lower Ex- tremity Arterial Disease

Objective To explore the effect of intensive insulin therapy on the level of oxidative stress in diabet- ic lower extremity arterial disease （ LEAD）. Methods A total of 60 patients with type 2 diabetes mellitus （T2DM） were divided into two groups according to the ankle braehial index （AB1） ： LEAD group （ n = 28, ABI 〈 0.9） and not com- bined with LEAD group （NC group, n = 32, ABI≥0. 9） , and underwent intensive insulin therapy for 14 d. levels of fasting plasma glucose （FPG） , 2 h postprandial glucose （2hPG） , glycated albumin （GA） , homocysteine （Hcy） , 3- ni- trotyrosine （3-NT） and 8-hydroxydeoxyguanosine （8-OHdG） before and after treatment in the two groups were detected, and each index was compared and analyzed. Results levels of Hey, 3-NT and 8-OhdG in LEAD group were higher than those in NC group before treatment （P 〈 0.01 ）. levels of FPG, 2hPG and GA were obviously decreased after intensive insulin treatment in the two groups, compared with those before treatment （P 〈0.01 ） , and levels of Hey, 3-NT and 8- OhdG were also significantly decreased, compared with those before treatment （P 〈 0.05, P 〈 0.01 ） , and decrease in NC group was more significant. Conclusion The levels of blood glucose and oxidative stress can be decreased following intensive insulin treatment, and patients without lower extremity arterial disease may have better improvement.