糖尿病性心肌病变患者血糖强化治疗前后血管内皮功能变化的研究

Alternation of the function of vascular endothelium after intensive insulin treatment in diabetic cardiomyopathy patients

目的评价糖尿病性心肌病(DCM)患者胰岛素泵强化治疗前后血管内皮细胞功能的变化。方法 30例DCM患者采用胰岛素泵强化治疗,治疗达标前后通过超声方法分别进行肱动脉血流介导的血管舒张功能(FMD)检测比较。结果胰岛素泵强化治疗后,患者氧化应激水平明显降低(P<0.01)、血脂、血糖、游离脂肪酸、胰岛素抵抗明显改善(P<0.01)、FMD水平明显升高(P<0.01)。结论 DCM患者临床使用胰岛素泵强化治疗后血管内皮功能明显改善,可能通过改善氧化应激及糖脂毒性起作用。

Objective To evaluate the effect of intensive insulin treatment on the endothelium function of di- abetic cardiomyopathy （DCM） patients. Methods Thirty DCM patients were treated with continually subcutaneous insulin injection. Flow-mediated vasodilatation （FMD） was measured after insulin pump therapy. Results After the intensive insulin treatment ,the oxidative stress level reduced significantly （P 〈 0.01 ）, serum lipid, glucose, free fatty acid and insulin resistance showed significant improvement （ P 〈 0.01 ）, the FMD lever increased obviously （ P 〈 0.01 ）. Conclusion Endothelium function of the DCM patients could significantly be improved by intensive insulin treatment.