·糖尿病临床研究·

　　【摘要】 目的 探讨不同干预方式对新诊断T2DM患者胰岛功能和血清色素上皮衍生因子(PEDF)的影响。 方法 将60例新诊断T2DM患者随机分为胰岛素泵(CSII)组和口服降糖药(OHA)组，血糖达标后维持治疗1周。观察胰岛功能和血清PEDF水平的变化。 结果 与治疗前相比，治疗后CSII和OHA组FPG[(9.6±2.1) vs (7.1±1.2) mmol/L、(9.4±1.2) vs (6.9±0.9) mmol/L，P<0.01]和TG[(2.6±1.5) vs (1.8±1.2) mmol/L、(2.6±1.2) vs (1.9±1.1) mmol/L，P<0.05]均下降;稳态模型评估胰岛素分泌指数(HOMA-B)有改善[40(19，56) vs 61(40，81)、42(16，57) vs 63(25，80)，P<0.05]，但早期相胰岛素分泌指数仅在CSII组改善[2.2(0.8，3.3) vs 5.5(1.8，7.1)，P<0.01];血清PEDF水平下降[(5.3±3.3) vs (2.2±1.6) mg/L、(5.4±3.1) vs (3.3±1.6) mg/L，P<0.01]，且CSII组下降更明显。 结论 CSII和OHA均能降低PEDF水平以及改善胰岛功能，但CSII治疗后PEDF降低更显著，且早期相胰岛素分泌得到改善。

　　【关键词】 2型糖尿病;胰岛素泵;色素上皮衍生因子

　　【Abstract】 Objective To investigate the effect of different therapies on islet beta cell function and serum pigment epithelium-derived factor (PEDF) in newly diagnosed T2DM patients. Methods 60 patients with newly diagnosed T2DM were randomly divided into continuous subcutaneous insulin infusion (CSII) and oral hypoglycaemic agent (OHA) group. Patients continued to maintain therapy for 1 week after achieving glycaemic control target. Serum PEDF level was measured at baseline and after treatment. Results The levels of FPG [(9.6±2.1) vs (7.1±1.2) mmol/L; (9.4±1.2) vs (6.9±0.9) mmol/L, P<0.01, respectively] and TG [(2.6±1.5) vs (1.8±1.2) mmol/L; (2.6±1.2) vs (1.9±1.1) mmol/L, P<0.05, respectively] were significantly improved in both CSII and OHA group. HOMA-B was increased after treatment in CSII and OHA group[40(19, 56) vs 61(40, 81); 42(16, 57) vs 63(25, 80), P<0.05, respectively], while early-phase insulin secretion index (ΔI30/ΔG30) was improved only in CSII group[2.2(0.8, 3.3) vs 5.5(1.8, 7.1), P<0.01]. Serum PEDF levels were inhibited after CSII and OHA therapy[(5.3±3.3) vs (2.2±1.6) mg/L; (5.4±3.1) vs (3.3±1.6) mg/L, P<0.01, respectively], and decrement of PEDF levels in CSII group was markedly greater than in OHA group. Conclusion In newly diagnosed T2DM patients, both CSII and OHA therapy have similar effect on improving glucose and lipid control. The increment of ΔI30/ΔG30 and decrement of PEDF are markedly greater in CSII group than in OHA group.

　　【Key words】 Diabetes mellitus, type 2; Continuous subcutaneous insulin infusion (CSII); Pigment epithelium-derived factor (PEDF)