精蛋白锌重组赖脯胰岛素混合注射液对2型糖尿病患者糖代谢与免疫功能的影响及其炎症机制研究

Effect of mixed protamine zinc recombinant human insulin lispro injection on glucose metabolism,immune function in patients with type 2 diabetes and its inflammatory mechanisms

目的探讨精蛋白锌重组赖脯胰岛素混合注射液对2型糖尿病患者糖代谢、免疫功能的影响及其炎症机制研究。方法将纳入的125例患者根据随机数字表法随机分为对照组(n=61)和观察组(n=64)。对照组给予常规治疗,观察组在此基础上结合精蛋白锌重组赖脯胰岛素混合注射液治疗,疗程均为3个月。对比分析2组治疗前后空腹血糖(fasting blood glucose,FBG)、餐后2h血糖(2h post prandial blood glucose,2hPG)、糖化血红蛋白(glycatedhemoglobin,Hb A1c)、空腹胰岛素、胰岛素抵抗指数(insulin resistance index,IRI)、CD4+、CD8+、CD4+/CD8+变化及炎症因子水平的变化。结果 2组FBG、2hPG、Hb A1c治疗后均较治疗前显著降低(P<0.05),观察组FBG、2hPG、Hb A1c治疗后显著低于对照组(P<0.05)。2组治疗后空腹胰岛素和IRI均较治疗前显著降低(P<0.05),观察组治疗后空腹胰岛素和IRI显著低于对照组(P<0.05)。2组治疗后CD8+较治疗前显著降低(P<0.05),CD4+、CD4+/CD8+较治疗前显著增加(P<0.05),观察组治疗后CD8+显著低于对照组(P<0.05),CD4+、CD4+/CD8+显著高于对照组(P<0.05)。2组治疗后TNF-α、IL-6、CRP显著低于治疗前(P<0.05),观察组治疗后TNF-α、IL-6、CRP显著低于对照组(P<0.05)。结论精蛋白锌重组赖脯胰岛素混合注射液可明显改善2型糖尿病患者糖代谢,增强其免疫功能,减轻炎症反应,从而降低其心血管事件的发生。

Objective To investigate the mixed protamine zinc recombinant human insulin lispro injection on glucose metabolism, immune function in patients with type 2 diabetes and its inflammatory mechanisms.Methods 125 patients enrolled were randomly divided into two groups according to the random number table： control group （n =61） and observation group （n =64）.The control group were received conventional treatment, observation group were received mixed protamine zinc recombinant human insulin lispro injection on the basis of control group, with a course of three months of both groups.The fasting blood glucose （FBG）, 2h post prandial blood glucose （2hPG）, glycated hemoglobin （HbA1c）, fasting insulin, insulin resistance index （ IRI） , CD4^＋, CD8^＋, CD4^＋/CD8^＋changes and inflammatory cytokines levels were compared before and after treatment between two groups. Results The level of FBG, 2hPG, HbA1c after treatment was respectively lower than that before treatment in both groups （P〈0.05）, and the above indexes of observation group after treatment was respectively lower than that of control group （P〈0.05）.The level of fasting insulin, IRI after treatment was respectively lower than that before treatment in both groups （P〈0.05）, and the above indexes of observation group after treatment was respectively lower than that of control group （P〈0.05）.The level of CD8^＋was lower, CD4^＋, CD4^＋/CD8^＋was higher after treatment than that before treatment in both groups, respectively （P〈0.05）, and the CD8^＋level of observation group after treatment was lower, CD4^＋, CD4^＋/CD8^＋was higher than that of control group, respectively （P〈0.05）.The level of TNF-α, IL-6, CRP after treatment was respectively lower than that before treatment in both groups （P〈0.05）, and the above indexes of observation group after treatment was respectively lower than that of control group （P〈0.05）.Conclusion The mixed protamine zinc recombinant human insulin lispro injection can significantly improve glucose metabolism in patients with type 2 diabetes, and enhance immune function, reduce inflammation, thereby reducing the incidence of cardiovascular events.