胰岛素超声导入与皮下注射的临床疗效比较

　　·糖尿病的胰岛素治疗·

　　王尧 黄欢 孙子林

　　作者单位：210009南京，东南大学附属中大医院内分泌科(王尧、孙子林);南京市浦口医院(黄欢)

　　通讯作者：孙子林，E-mail:sunzilin1963@yahoo.com.cn

　　【摘要】 目的 观察胰岛素超声导入与皮下注射两种给药方式疗效的差异。 方法 符合条件的2型糖尿病(T2DM)患者20例，随机分为先皮下注射后超声(SU)组10例：试验前3 d皮下注射甘精胰岛素(来得时)，后3 d超声导入相同剂量来得时;先超声后皮下注射(US)组10例：试验前3 d超声导入来得时，后3 d皮下注射相同剂量来得时。用动态血糖监测系统(CGMS)监测血糖，于第1、3、6天留血测胰岛素、C肽,比较皮下注射与超声导入各3 d不同时间点血糖、日平均血糖水平(MBG)、最大血糖波动幅度(LAGE)、不同时间段血糖波动(GE)的平均值和第3、6天外源性胰岛素及体内C肽。 结果 给予相同剂量的胰岛素，超声组较皮下组血糖值除在6：00、19：00明显升高外，其余各点无统计学差异;两组MBG、LAGE、GE值、外源性胰岛素、C肽均无统计学差异。 结论 胰岛素超声导入具有较好的降糖效果，与皮下注射相比MBG、血糖波动幅度等均相似;两种给药方式胰岛素生物利用度相似，对内源性胰岛功能的影响无显著性差异。

　　doi:10.3969/j.issn.1006-6187.2011.06.003

　　The comparison of pharmacodynamics between ultrasonic delivery and subcutaneous injection of insulin

　　WANG Yao, HUANG Huan, SUN Zi-lin. Department of Endocrinology, Affiliated Zhongda Hospital, Southeast University Clinical Medical School, Nanjing 210009,China

　　Corresponding author:SUN Zi-lin,E-mail:zunzilin1963@yahoo.com.cn

　　【Abstract】 Objective

　　To compare the similarities and differences in pharmacodynamic between ultrasonic delivery and subcutaneous injection of insulin glargine. Methods The 20 eligible patients with T2DM were randomly divided into two groups. In SU group, subcutaneous injection of insulin at the first three days, then ultrasonic delivery of the same dose insulin in the sequential three days. In US goup, ultrasonic delivery of insulin glargine at the first three days, then subcutaneous injection of insulin in the sequential three days.CGMS was used for monitoring BG,and venous blood was collected at the 1,3,6-day to determine insulin and C-peptide. The average of the different time points BG, 24 h MBG, LAGE, and GE in different time periods of each three days were compared between two groups, meanwhile the insulin and C- peptide at the third and sixth day were compared. Results Under the same dose of insulin, the BG at 06:00,19:00 time points was statistically higher by ultrasonic delivery than by subcutaneous injection, there was no obvious difference at other time points. The 24 h MBG, LAGE, GE, exogenous insulin dose, and the C-peptide showed no significant difference between two Methods . Conclusion s 1.The ultrasonic delivery of insulin has good hypoglycemic effect, similar to subcutaneous injection at average BG and GE. 2.The ultrasonic delivery is similar to subcutaneous injection at insulin bioavailability. 3.The ultrasonic delivery and subcutaneous injection have similar effects of endogenous insulin secretion.

　　【Key words】Diabetes mellitus, type 2; Ultrasonic delivery; Subcutaneous injection