门冬胰岛素30强化治疗对初诊2型糖尿病颈动脉内中膜厚度及弹性的影响

Carotid Intima-media Thickness and Elasticity in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

目的探讨门冬胰岛素30强化治疗对初诊2型糖尿病(T2DM)颈动脉内中膜厚度(cIMT)及弹性的影响。方法新诊断T2DM患者112例,其中10例受试者于观察过程中出现脱落或失访,余102例患者随机分2组,即强化治疗组48例,采用门冬胰岛素30强化治疗;非强化治疗组54例,不设定严格的治疗控制目标。2组的疗程均为12周。收集2组患者的血压、体质量指数、空腹及餐后血糖、血脂和HbA1c等资料。使用高分辨率彩色血管多普勒超声仪测定治疗前后的cIMT及颈动脉弹性参数。结果强化治疗组cIMT及颈动脉弹性参数较治疗前无明显变化(P>0.05)。非强化治疗组cIMT较治疗前显著增加,平均厚度超过颈动脉病变的切点1.0 mm水平,颈动脉的弹性系数明显增高,顺应性参数明显下降(P<0.05)。结论使用门冬胰岛素30短期的强化治疗可能有助于保护T2DM患者的血管内皮细胞,延缓其动脉粥样硬化过程。

Objective To evaluate the therapeutic effect of intensive application of insulin aspart 30 on carotid intima-media thickness（cIMT） and elasticity in patients with newly diagnosed type 2 diabetes mellitus（T2DM）.Methods One hundred and twelve patients with newly diagnosed T2DM were enrolled in the study and due to 10 withdrawals the remaining 102 were randomly divided into an intensive group,48 patients,and a non-intensive group,54 patients.The intensive group was treated with insulin aspart 30.The non-intensive group received traditional or routine treatment.The clinical parameters such as fasting plasma glucose,total cholesterol,triglyceride,blood pressure,body weight and HbA1c,were assessed at the beginning and end of the 12-week therapy.cIMT and carotid elasticity parameters of the patients were evaluated with high-resolution ultrasonography.Results After 12 weeks,there were no significant differences of cIMT and carotid elasticity parameters in the intensive group（P〉0.05）while in the non-intensive group there were significantly higher cIMT and worse carotid elasticity parameters（Ep and AC） than those at the beginning（P〈0.05）.Conclusion Intensive application of insulin aspart 30 may prevent the progression of atherosclerosis in patients with newly diagnosed T2DM.