强化注射胰岛素治疗T2DM合并MSI患者的临床疗效

Clinical Effect of Intensive Insulin Injection on T2DM Patients with MSI

【目的】探讨强化注射胰岛素治疗2型糖尿病(T2DM)合并颌面部多间隙感染(MSI)的临床疗效。【方法】选择2017年2月至2022年2月宝鸡高新医院和扶风县人民医院收治的80例T2DM合并MSI患者,按照随机数字表法分为对照组和观察组,每组40例。对照组接受口服降糖药治疗,观察组接受胰岛素强化治疗。比较两组治疗前后血糖水平[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、胰岛功能指标[稳态模型评估胰岛素抵抗指数(HOMA-IR)和稳态模型评估β细胞功能指数(HOMA-β)]、炎症因子[肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)和白介素6(IL-6)]、氧化应激水平[超氧化物歧化酶(SOD)、丙二醛(MDA)和还原型谷胱甘肽(GSH)]、牙周指数[龈沟出血指数(SBI)评分、牙周探诊深度(PD)和附着丧失(AL)]及血糖达标时间、切开引流伤口愈合时间。【结果】与治疗前比较,两组治疗后FPG、2hPG和HbA1c、HOMA-IR、TNF-α、CRP、IL-6、MDA、SBI评分、PD、AL明显降低(P<0.05),SOD、GSH、HOMA-β明显升高(P<0.05),且观察组变化更为明显(P<0.05)。观察组血糖达标时间和切开引流伤口愈合时间明显短于对照组(P<0.05)。【结论】胰岛素强化治疗T2DM合并MSI具有良好效果,可有效控制血糖水平,缩短血糖达标时间和切开引流伤口愈合时间,改善胰岛功能和牙周指数,抑制氧化应激和炎症反应。

【Objective】To explore the clinical effect of intensive insulin injection on type 2 diabetes mellitus(T2DM)complicated with maxillofacial multiple space infection(MSI).【Methods】A total of 80 patients with T2DM combined with MSI who were admitted to Baoji High Tech Hospital and Fufeng County People's Hospital from February 2017 to February 2022 were selected and divided into control group and observation group according to random number table,with 40 patients in each group.The control group received oral hypoglycemic drugs,while the observation group received intensive insulin therapy.The following indexes were compared between the two groups before and after treatment:blood glucose level[FPG,2hPG,HbA1c],Insulin function index[HOMA-IR and homeostasis model evaluationβCell function index(HOMA-β)],inflammatory factor[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)],oxidative stress level[superoxide dismutase(SOD),malondialdehyde(MDA)and reduced glutathione(GSH)],periodontal index[sulcus bleeding index(SBI)score,periodontal probing depth(PD),attachment loss(AL)],the time of blood glucose reaching the standard and the time of incision and drainage wound healing.【Results】Compared with that before treatment,FPG,2hPG,HbA1c,HOMA-IR,TNF-α,the scores of CRP,IL-6,MDA,SBI,PD and AL in the two groups after treatment decreased significantly(P<0.05);SOD、GSH、HOMA-βwere significantly increased(P<0.05),and the change was more obvious in the observation group(P<0.05).The time of blood glucose reaching the standard and the healing time of incision and drainage wound in the observation group were significantly shorter than those in the control group(P<0.05).【Conclusion】Intensive insulin therapy for T2DM with MSI has a good effect,which can effectively control the blood glucose level,shorten the time of reaching the blood glucose standard and the time of wound healing after incision and drainage,improve the function of pancreatic islets and periodontal index,and inhibit oxidative stress and inflammatory reaction.