胰岛素泵短期强化治疗对糖尿病合并足溃疡患者氧化应激状态的影响

Influences of short-term insulin pump intensive treatment on oxidative stress in patients with diabetic foot ulcer

目的探讨胰岛素泵短期强化治疗对糖尿病合并足溃疡患者氧化应激状态的影响。方法将88例糖尿病合并足溃疡患者随机分为观察组和对照组各44例,对照组接受常规皮下注射胰岛素治疗,观察组接受短期胰岛素泵强化治疗方案,记录两组患者治疗前后的血浆丙二醛含量(MDA)、超氧化物歧化酶水平(SOD)、空腹血糖水平(FPG)、糖化血红蛋白(Hb A1c)、餐后2 h血糖(2 h PG)和溃疡面积,并记录治疗两周后的溃疡愈合情况。结果观察组治疗后1周、2周后的MDA、Hb A1c、2 h PG和FPG均低于对照组(P<0.05),治疗后1周、2周后的SOD均高于对照组(P<0.05);溃疡面积在治疗后1周、2周亦显著小于对照组(P<0.05);Pearson线性相关分析显示:治疗前及治疗后1周、2周的MDA与溃疡面积呈正相关(P<0.05),而治疗前及治疗后1周、2周的SOD与溃疡面积呈负相关(P<0.05)。结论胰岛素泵短期强化治疗可以有效改善糖尿病合并足溃疡患者各项指标,减轻氧化应激状态,从而促进糖尿病患者溃疡的愈合。

Objective To discuss the influences of short-term insulin pump intensive treatment on oxidative stress in patients with diabetic foot ulcer. Methods Eighty-eight patients with diabetic foot ulcer were randomly di-vided into observation group （n=44） and control group （n=44）. The control group received routine subcutaneous injec-tions of insulin therapy, and observation group received short-term insulin pump intensive treatment. Plasma malondial-dehyde （MDA）, superoxide dismutase （SOD）, fasting plasma glucose （FPG）, glycosylated hemoglobin （HbA1c）, 2 h post-prandial blood glucose （2 hPG）, ulcer area were recorded before and after treatment. Results MDA, HbA1c, 2 hPG, FPG of the observation group were significantly lower than those of control group after 1, 2 weeks of treatment （P〈0.05）, while SOD was significantly higher than that of control group after 1, 2 weeks of treatment （P〈0.05）. Ulcer area of the observation group was significantly less than that of control group after 1, 2 weeks of treatment （P〈0.05）. Pearson correlation analysis showed that MDA were positively correlated with ulcer area before and after 1, 2 weeks of treatment （P〈0.05）, while SOD were negatively correlated with ulcer area before and after 1, 2 weeks of treatment （P〈0.05）. Conclusion Short-term insulin pump intensive therapy can effectively improve the indicators of patients with diabetic foot ulcers, and decrease oxidative stress so as to promote the healing of ulcer in patients.