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目的研究新诊断2型糖尿病患者经甘精胰岛素治疗前后血清炎症因子白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的变化,探究甘精胰岛素治疗对慢性炎症反应的影响。方法选择2012年1月至2013年2月新诊断的2型糖尿病患者60例,按随机数字表法分为甘精胰岛素治疗组和二甲双胍治疗组,同时选择基线资料匹配的健康体检者24例作为对照组。观察各组对象在治疗前后空腹血糖(FPG)、餐后血糖(PBG)、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、总胆固醇(TC)以及血清IL-6、TNF-α等指标的变化。结果 (1)与对照组比较,治疗前甘精胰岛素组和二甲双胍组FPG、PBG、Hb A1c、TG、IL-6、TNF-α均明显升高(P均<0.05);(2)与治疗前相比,治疗后甘精胰岛素组和二甲双胍组FPG、PBG、TG、Hb A1c、IL-6、TNF-α均降低(P均<0.05);(3)治疗后甘精胰岛素组FPG、Hb A1c、IL-6、TNF-α的降低差值大于二甲双胍组(P均<0.05)。结论甘精胰岛素和二甲双胍治疗均能有效降低新诊断2型糖尿病患者的血糖水平,同时能降低血清IL-6、TNF-α等炎症因子水平,从而改善慢性炎症反应,且甘精胰岛素的作用更为明显。
Objective To study the changes of serum inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with newly diagnosed type 2 diabetes mellitus before and after treatment with insulin glargine to investigate the effects of insulin glargine treatment on chronic inflammatory response Impact. Methods Sixty patients with newly diagnosed type 2 diabetes mellitus from January 2012 to February 2013 were randomly divided into insulin glargine group and metformin group according to the random number table method. 24 healthy subjects who matched baseline data were selected as the Control group. The levels of fasting blood glucose (FPG), postprandial blood glucose (PBG), Hb A1c, triglyceride (TG), total cholesterol (TC), serum IL-6 and TNF- The change. Results (1) Compared with the control group, FPG, PBG, Hb A1c, TG, IL-6 and TNF-αin the glargine group and the metformin group were significantly increased (all P <0.05) FPG, PBG, TG, Hb A1c, IL-6 and TNF-α in glargine group and metformin group were significantly decreased after treatment (P <0.05); (3) FPG and Hb The difference of A1c, IL-6 and TNF-αdecreased more than that of metformin group (all P <0.05). Conclusion Both insulin glargine and metformin can effectively reduce the blood glucose level in patients with newly diagnosed type 2 diabetes mellitus and at the same time decrease the levels of inflammatory cytokines such as IL-6 and TNF-α in serum so as to improve the chronic inflammatory response, and the effect of insulin glargine is more Obvious.