短期胰岛素泵强化对初诊2型糖尿病并阿尔茨海默病患者氧化应激及炎症反应的影响

Influence of short-term intensive treatment with insulin pump on oxidative stress and inflammatory reaction in newly diagnosed type 2diabetes mellitus complicated with Alzheimers disease

目的观察初诊2型糖尿病并阿尔茨海默病患者应用短期胰岛素泵强化治疗后超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、白细胞介素-6(interleukin-6,IL-6)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)水平的变化。方法 69例初诊2型糖尿病并阿尔茨海默病患者均给予胰岛素泵强化治疗4周,测定治疗前、后空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白A1c(glycosylated hemoglobin A1c,HbA1c)、总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、SOD、MDA、IL-6、hs-CRP水平,并进行比较。结果治疗后患者FBG((5.58±1.36)mmol/L)、HbA1c((6.35±1.72)mmol/L)、TC((4.67±0.48)mmol/L)、TG((1.74±0.33)mmol/L)、LDL-C((1.85±0.69)mmol/L)、SOD((53.39±4.74)u/mL)、MDA((4.37±1.84)μmol/L)、IL-6((7.25±1.58)ng/L)、hs-CRP((187.64±7.36)μg/L)较治疗前(FBG(10.51±1.79)mmol/L、HbA1c(7.98±1.46)mmol/L、TC(6.52±0.91)mmol/L、TG(3.59±0.72)mmol/L、LDL-C(3.56±0.27)mmol/L、SOD(81.36±3.59)u/mL、MDA(8.31±1.25)μmol/L、IL-6(10.46±2.69)ng/L、hs-CRP(206.37±5.82)μg/L)下降(P<0.05或P<0.01),HDL-C水平与治疗前比较差异无统计学意义(P>0.05)。结论初诊2型糖尿病并阿尔茨海默病患者应用短期胰岛素泵强化治疗可有效控制血糖,降低血脂,减轻氧化应激和炎症反应引起的损害。

Objective To observe the changes of superoxide dismutase（SOD）,malondialdehyde（MDA）,interleukin-6（IL-6）and high sensitivity C-reactive protein（hs-CRP）after short-term intensive treatment with insulin pump in newly diagnosed patients with type 2diabetes mellitus（T2DM）and Alzheimers disease.Methods Sixty-nine patients with newly diagnosed T2 DM and Alzheimers disease received short-term intensive treatment with insulin pump for 4weeks.The levels of fasting plasma glucose（FPG）,glycosylated hemoglobin A1c（HbA1c）,total cholesterol（TC）,triacylglycerol（TG）,high density lipoprotein-cholesterol（HDL-C）,low density lipoprotein-cholesterol（LDL-C）,SOD,MDA,IL-6and hs-CRP were detected before and after treatment and compared between two groups.Results The levels of FPG,HbA1 c,TC,TG,LDL-C,SOD,MDA,IL-6and hs-CRP were significantly lower after treatment（FBG：（5.58±1.36）mmol/L,HbA1c：（6.35±1.72）mmol/L,TC：（4.67±0.48）mmol/L,TG：（1.74±0.33）mmol/L,LDL-C：（1.85±0.69）mmol/L,SOD：（53.39±4.74）u/mL,MDA：（4.37±1.84）μmol/L,IL-6：（7.25±1.58）ng/L,hs-CRP：（187.64±7.36）μg/L）than those before treatment（FPG：（10.51±1.79）mmol/L,HbA1c：（7.98±1.46）mmol/L,TC：（6.52±0.91）mmol/L,TG：（3.59±0.72）mmol/L,LDL-C：（3.56±0.27）mmol/L,SOD：（81.36±3.59）u/mL,MDA：（8.31±1.25）μmol/L,IL-6：（10.46±2.69）ng/L,hs-CRP：（206.37±5.82）μg/L）（P〈0.05,P〈0.01）,and there was no significant difference in the HDL-C level before and after treatment（P〉0.05）.Conclusion For newly diagnosed T2 DM complicated with Alzheimers disease,short-term intensive treatment with insulin pump can effectively control the plasma glucose and lipid,as well as reduce the damage induced by oxidative stress and inflammation.