胰岛素泵强化治疗对新诊断2型糖尿病患者丙氨酸氨基转移酶的影响

Effect of intensive insulin therapy on alanine aminotransferase in newly diagnosed type 2 diabetic mellitus patients

目的探讨短期胰岛素强化治疗对新诊断2型糖尿病患者丙氨酸氨基转移酶水平的影响。方法 62例新诊断2型糖尿病患者,均应用胰岛素泵强化治疗方案治疗4周,比较治疗前后丙氨酸氨基转移酶(ALT)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2小时血糖(2 hPG)、空腹胰岛素(FINS),计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI)。结果治疗4周后,患者ALT为(33.4±8.9)U/L、HbA1c为(7.16±1.48)%、FPG为(6.24±0.57)mmol/L、2 hPG为(8.92±3.01)mmol/L、HOMA-IR为(2.61±0.75),均低于治疗前的(39.7±7.8)U/L、(10.11±1.35)%、(13.25±1.57)mmol/L、(17.61±5.64)mmol/L、(5.26±0.96),ISI为(4.75±0.20),高于治疗前的(4.05±0.32),差异均具有统计学意义(P<0.05);治疗前后FINS比较差异无统计学意义(P>0.05)。结论短期胰岛素强化治疗可有效改善2型糖尿病患者的胰岛素抵抗,降低丙氨酸氨基转移酶水平,值得临床推广应用。

Objective To discuss the effect of short-term intensive insulin therapy on alanine aminotransferase in newly diagnosed type 2 diabetic mellitus patients.Methods A total of 62 newly diagnosed type 2 diabetic mellitus patients all received intensive insulin therapy for 4 weeks.The levels of alanine aminotransferase（ALT）,glycosylated hemoglobin（HbA1c）,fasting plasma glucose（FPG）,2 hour postprandial glucose（2 hPG） and fasting insulin（FINS） were compared before and after treatment,and homeostasismodel assessment insulin resistance（HOMA-IR） index and insulin sensitivity index（ISI） were calculated.Results After 4 weeks of treatment,patients had ALT as（33.4±8.9） U/L,HbA1c as（7.16±1.48）%,FPG as（6.24±0.57） mmol/L,2 hPG as（8.92±3.01） mmol/L and HOMA-IR as（2.61±0.75）,which were all lower than（39.7±7.8） U/L,（10.11±1.35）%,（13.25±1.57） mmol/L,（17.61±5.64） mmol/L,（5.26±0.96） before treatment,and higher ISI as（4.75±0.20） than（4.05±0.32） before treatment.Their difference was statistically significant（P0.05）.Patients had no statistically significant difference in FINS before and after treatment（P0.05）.Conclusion Short-term intensive insulin therapy can effectively improve insulin resistance of patients with type 2 diabetic mellitus,and lower level of alanine aminotransferase.It is worthy of clinical promotion and application.