初诊2型糖尿病短期胰岛素泵强化治疗对血清炎症因子及胰岛功能的影响

目的：观察短期胰岛素泵强化治疗对初诊2型糖尿病患者（T2DM）血清C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）水平及胰岛β细胞功能的影响。方法：初诊T2DM患者64例，应用胰岛素泵强化治疗14 d，比较治疗前后血清CRP、TNF-α、IL-6、胰岛素分泌指数（HOMA-IS）、胰岛素抵抗指数（HOMA-IR）的变化，并与38例健康对照组人群进行比较。结果：T2DM患者治疗前血清CRP、TNF-α、IL-6水平较正常对照组明显升高（P<0.01）；强化治疗后较治疗前血清CRP、TNF-α、IL-6水平明显降低（P<0.01），HOMA-IS明显升高（P<0.01），而HOMA-IR则明显降低（P<0.01）。结论：初诊T2DM患者存在慢性炎症反应，胰岛素具有抗炎作用，胰岛素强化治疗可改善患者糖代谢，减轻胰岛素抵抗，从而降低炎症因子的表达。

Effect of serum inflammatory factors and islet function in newly diagnosed type 2 diabetes with insulin pump intensive therapy

OBJECTIVE To observe effect of C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), interleukin -6 (IL-6) levels and islet β-cell function in newly diagnosed type 2 diabetes with short-term insulin pump intensive therapy. METHODS Sixth-four newly diagnosed T2DM patients were intensively therapied with insulin pump in 14 days, compared with changes of serum CRP, TNF-α, IL-6, insulin secretion index (HomaIS), insulin resistance index (HomaIR) before and after treatment respectively, and compared with 38 cases of healthy control. RESULTS The serum CRP, TNF-α, IL-6 levels in T2DM patients were higher than there were in healthy cases(P<0.01), and there were significantly lower after insulin pump therapy in T2DM patients (P<0.01).HOMA-IS was significantly higher than that before treatment (P<0.01), while HOMA-IR was significantly lower than that before treatment (P<0.01) in T2DM patients. CONCLUSION Newly diagnosed T2DM patients have chronic inflammatory reaction, insulin has certain anti-inflammatory effects.Insulin intensively therapy could improve glucose metabolismsom and reduce insulin resistance, so it could reduce the expression of inflammatory factors.