预防管理体系对2型糖尿病胰岛素抵抗患者糖脂代谢及脂肪因子的影响

Effects of Preventive Management System on Glucose and Lipid Metabolism and Insulin Resistance in Type 2 Diabetic Patients with Insulin Resistance

目的:探讨预防管理体系对2型糖尿病胰岛素抵抗(IR)患者糖脂代谢及脂肪因子的影响。方法:将168例2型糖尿病患者随机分为对照组和干预组各84例,对照组采用常规护理干预,干预组在此基础上采取预防管理体系,干预40周后比较两组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDC-C)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)、血脂、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)及分泌型卷曲相关蛋白5(SFRP5)水平。结果:干预后两组FPG、2 h PG、Hb A1c、BMI、FINS、TC、TG、LDC-C、HOMA-IR、TNF-α及IL-6水平均低于干预前(P<0.01,P<0.05),SFRP5水平较干预前显著增高(P<0.05);干预组上述各指标均优于对照组(P<0.01,P<0.05)。结论:预防管理体系可有效调节2型糖尿病患者的糖脂代谢,控制体重,并可影响IL-6、TNF-α、SFRP5等脂肪因子从而改善IR。

Objective： To investigate the effects of prevention and management system on glucose and lipid metabolism and insulin resistance in type 2 diabetic patients with insulin resistance（ IR）. Methods： A total of 168 type 2 diabetic patients were randomly divided into the control group and the intervention group,each with 84 cases. The control group received the routine nursing intervention,while the intervention group received the preventive management system on the basis of the control group. 40 weeks after the intervention,fasting blood glucose（ FPG）,2 h postprandial blood glucose（ 2 h PG）,glycosylated hemoglobin（ Hb A1c）,cholesterol（ TC）,triglyceride（ TG）,low density lipoprotein cholesterol（ LDC-C）,fasting insulin（ FINS） and homeostasis model assessment insulin resistance index（ HOMA-IR）,body mass index（ BMI）,blood lipid,interleukin 6（ IL-6）,tumor necrosis factor alpha（ TNF-alpha） and secreted frizzled related protein 5（ SFRP5） level were compared between two groups. Results： After the intervention,two groups＇ levels of FPG,2 h PG,Hb A1 c,BMI,FINS,TC,TG,LDC-C,HOMA-IR,TNF- alpha and IL-6 were significantly lower than those before the intervention（ P〈0. 01,P〈0. 05）. The level of SFRP5 was significantly higher than that before intervention（ P〈0. 05）. The intervention group was superior to the control group（ P〈0. 01,P〈0. 05）. Conclusion： Preventive management system can effectively regulate the glucose and lipid metabolism of type 2 diabetic patients,control body weight,and can affect IL-6,TNF-alpha,SFRP5 and other fat factors to improve IR.