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目的探讨胰岛素泵强化治疗对2型糖尿病(type 2 diabetes mellitus,T2DM)合并大血管病变患者血清亲环素A(Cyp A)和超敏C反应蛋白(hs-CRP)水平的影响。方法选择2014年11月—2015年6月在北京军区总医院内分泌科住院行胰岛素泵强化治疗的T2DM患者60例,按照有无大血管病变分为T2DM合并大血管病变(MCV)组(n=30)、T2DM无大血管病变(N-MCV)组(n=30),另选同期在医院体检、经口服葡萄糖耐量试验及相关大血管病变检查均正常的健康者20名作为健康对照(NC)组。对入组者进行临床资料收集,常规生化指标及Cyp A、hs-CRP检测。结果治疗前MCV组血清Cyp A、hs-CRP水平显著高于N-MCV组、NC组(P<0.01);Pearson相关性分析显示,Cyp A与Hb A1c、空腹血糖(FPG)和hs-CRP呈显著正相关(r=0.569、0.495、0.836,P<0.01),hs-CRP与Hb A1c、Cyp A、FPG呈显著正相关(r=0.392、0.296、0.836,P<0.01、P<0.05);胰岛素泵强化治疗后N-MCV组与MCV组FPG、Cyp A和hs-CRP均较治疗前显著下降(P<0.01)。结论血清Cyp A与hs-CRP在T2DM大血管病变发生、发展中可能起重要作用,胰岛素泵强化治疗能显著降低血清Cyp A、hs-CRP水平,对延缓T2DM大血管病变的发展有一定作用。
Objective To investigate the effects of intensive insulin pump therapy on the levels of serum CypA and hs-CRP in patients with type 2 diabetes mellitus complicated with macrovascular disease. Methods Sixty patients with T2DM undergoing intensive insulin pump in hospital from Department of Endocrinology, Beijing Military Region General Hospital from November 2014 to June 2015 were divided into two groups according to the presence or absence of macrovascular disease: T2DM with macrovascular disease (MCV) (n = 30), T2DM without macrovascular disease (N-MCV) group (n = 30), and another 20 normal healthy subjects who were examined in the hospital, oral glucose tolerance test and related macroangiopathy in the same period were selected as healthy controls )group. The patients were collected for clinical data, routine biochemical indicators and Cyp A, hs-CRP test. Results The levels of Cyp A and hs-CRP in MCV group were significantly higher than those in N-MCV group and NC group before treatment (P <0.01). Pearson correlation analysis showed that there was no significant difference in Cyp A, Hb A1c, FPG and hs-CRP (R = 0.569,0.495,0.836, P <0.01). There was a significant positive correlation between hs-CRP and Hb A1c, Cyp A and FPG (r = 0.392,0.296,0.836, P <0.01, P < The levels of FPG, Cyp A and hs-CRP in N-MCV group and MCV group were significantly decreased after insulin pump treatment (P <0.01). Conclusions Serum Cyp A and hs-CRP may play an important role in the occurrence and development of T2DM macroangiopathy. Intensive insulin pump therapy can significantly reduce the serum levels of Cyp A and hs-CRP, which may play a role in delaying the development of T2DM macroangiopathy.