韩瑛 吕肖锋

　　作者单位：100700北京，北京军区总医院内分泌科

　　通讯作者：吕肖锋，E-mail：neifenmike@126.com

　　【摘要】目的　　观察早期胰岛素泵治疗对新诊断的2型糖尿病(T2DM)患者血胰升血糖素样肽1(GLP-1)的影响。方法选择T2DM患者100例，根据病程分为两组:试验组40例，为新诊断的T2DM患者(病程<1年);对照组60例，为T2DM患者(病程1～10年)。两组均使用胰岛素泵持续皮下输注超短效胰岛素门冬胰岛素(诺和锐)2周。比较两组FPG、2hPG、糖化血清白蛋白(GA)、空腹GLP-1、FC-P等变化情况及其相关性。结果治疗后两组FPG、2hPG、GA、FC-P、空腹GLP-1的差异均有统计学意义(P<0.05);两组治疗前后变化量比较有统计学意义(P<0.05)。GLP-1与FC-P呈正相关，与FPG、2hPG及GA呈负相关。结论早期胰岛素泵治疗能够很好控制血糖，促进胰岛功能恢复。对于新诊断的糖尿病患者，GLP-1显著升高，表明胰岛素泵早期治疗在改善β细胞功能、部分恢复餐后胰岛素早时相分泌方面有重要作用，而这种作用在1年以上病程的患者中表现相对不明显。

　　【关键词】糖尿病，2型;胰岛素泵;胰升血糖素样肽1;糖化血清白蛋白

　　doi:10.3969/j.issn.1006-6187.2011.02.011

　　The effect of early CSII on serum GLP-1 in newly-diagnosed type 2 diabetic patients

　　HAN Ying, L? Xiao-feng. Department of Endocrinology, Beijing Military General Hospital ,Beijing 100700, China

　　Corresponding author: L? Xiao-feng, E-mail:neifenmike@126.com

　　【Abstract】  Objective  To observe the effect of early CSII (continuous subcutaneous insulin infusion) with aspart insulin on serum GLP-1 (glucagon-like peptide-1).MethodsThe 100 T2DM patients treated with CSII of aspart insulin were divided into 2 groups: study group (n=40, newly diagnosed) and control group (n=60, 1-10 years course). Health group (n=30) was defined as healthy subject by health examination. FPG, 2hPG, fasting c-peptide and glucagon were assayed and compared between three groups.ResultsThe posttreatment increments in GLP-1, F-CP and GA were higher in study group [(0.72±0.35) mmol/L, (0.65±0.21 )nmol/L, (6.35±2.87) mmol/L, respectively] than in control group [(0.41±0.29) mmol/L, (0.36±0.12) nmol/L, (3.62±1.05) mmol/L, respectively] (all P<0.05). The posttreatment decrement in 2hPG and FPG were higher in study group than in control group (P<0.05). Serum GLP-1 was positively correlated with F-CP and negatively with FPG, 2hPG and GA (all P<0.05).  Conclusions  Early CSII used in T2DM may restore the serum GLP-1 and improve β-cell funetion.

　　【Key words】Diabetes mellitus，type 2;Insulin pump;Glucagon-like peptide-1; Glycated albumin