应用胰岛素泵强化治疗对糖尿病视网膜病变的影响

Effects of insulin pump intensive therapy on diabetic retinopathy

目的观察应用胰岛素泵强化治疗对糖尿病视网膜病变(DR)的影响。方法将入组的DR患者随机分为试验组及对照组,各26例52只眼。试验组予以行胰岛素泵强化治疗调控血糖稳定后改为皮下注射胰岛素治疗,对照组行多次皮下注射胰岛素调控血糖水平;监测两组患者的糖化血红蛋白(HbA1c)、空腹血清C肽(FCP)、餐后2 h C肽(PCP)水平及眼底荧光血管造影(FFA)情况。结果经治疗后试验组患者FCP、PCP升高、HbA1c水平降低均明显优于对照组(P<0.05),视网膜病变严重程度显著低于对照组(P<0.05);两组患者视力均有提高,但试验组改善优于对照组(P<0.05)。结论胰岛素泵强化治疗可影响DR进程,为DR的临床治疗提供新的思路。

Objective To investigate the effects of insulin pump intensive therapy on diabetic retinopathy. Methods Diabetic retinopa- thy patients were divided into 2 subgroups： 52 patients （104 eyes） in experimental group were treated with CSII firstly and then subcutaneous in- jection of insulin when glycemia was steady. 52 patients （ 104 eyes） in control group were treated with MSII to control glycemia. The glycosylated hemoglobin, fasting C - peptide, postprandial C - peptide and FFA were assessd and compared in both groups. Results Compared with the con- trol group, the experimental group had significant better level of FCP, PCP, HbA1 c and significant lower retinopathy severity （ P 〈 0.05 ）. Con- clusion Insulin pump intensive therapy could affect the diabetic retinopathy process and provide a new method for clinical treatment of diabetes retinoDathv.