论文标题:胰岛素强化治疗对糖尿病患者血糖及炎症因子的影响
Proinsulin Gene Therapy for Diabetic Rats
论文作者 沈备
论文导师 刘超,论文学位 硕士,论文专业 内科学
论文单位 南京医科大学,点击次数 74,论文页数 67页File Size2019k
2005-05-01论文网 http://www.lw23.com/lunwen_713831407/ 糖尿病;胰岛素泵;动态血糖监测;赖脯胰岛素;C反应蛋白
diabetes mellitus; insulin pump; continuous glucose monitoring system; lispro; C-reactive protein
目的:(1)评价持续血糖监测在糖尿病强化治疗中的价值;(2)比较持续皮下胰岛素输注和每日多点注射胰岛素两种强化治疗方案对慢性炎性因子的影响;(3)观察国产赖脯胰岛素强化治疗糖尿病的有效性与安全性。 方法:(1)对使用胰岛素泵强化治疗的糖尿病患者,同时进行三天的动态血糖和多点末梢血糖的检查,并统计分析结果的差异;(2)将初诊断的2型糖尿病患者随机分为两组,分别进行持续皮下胰岛素输注(CSII)和每日多点注射胰岛素(MDI)方案强化治疗,采用酶联免疫法分别测定比较治疗前后C反应蛋白(CRP)和细胞间粘附分子-1(ICAM-1)水平的差异;(3)对使用普通胰岛素治疗的患者,改用赖脯胰岛素强化治疗,观察治疗前后血糖、糖化血红蛋白的变化,以及低血糖的发生率。 结果:(1)在持续血糖与多点末梢血糖监测中,两组的最高与最低血糖存在显著性差异(P=0.0006、P=0.005),低血糖的检出率持续血糖检测组显著高于末梢血糖检查者,而平均血糖值两组无统计学差异(P=0.504)。(2)初诊的2型糖尿病患者采用CSII和MDI方案强化治疗后,CRP水平均显著降低,由治疗前2044.82±1801.93ng/ml、3167.73±1960.00ng/ml下降为1540.49±1205.29ng/ml、2014.10±1600.40ng/ml,但两种治疗组之间无统计学差异;治疗后,两组ICAM-1水平均有下降趋势,但都无统计学意义。(3)糖尿病患者由普通胰岛素改为国产赖脯胰岛素及优泌乐治疗12周后,赖脯胰岛素
Objective: l)To estimate the implication of Continuous Glucose Monitoring System continue (CGMS) in diabetic patients with intensive insulin therapy; 2)To investigate the effecs of intensive insulin therapy on the inflammatory factors in newly onset diabetics; 3) To study the efficacy and safety profiles of lispro on patients with diabetes. Methods: 1) CGMS and periphery capillary blood monitoring were used to detect the blood glucose levels in patients with diabetes on continuous subcutaneous insulin infusion(CSII); 2)38 Newly diagnosed diabetic patients were divided into multiple daily insulin injection group (MDI) and CSII group. All patients were treated with insulin for one month, serum C-reactive protein(CRP) and intercellular adhesion molecule-1(ICAM-1) were measured using euzymelinkedimmunosorbent assay (ELISA) before and after insulin treatment; 3 ) Diabetic patients who were treated with regular insulin routinely were switched to insulin lispro or Humalog for three months. Dosages were adjusted depending on blood glucose levels. Glycosylated hemoglobin and blood glucose were measured before and after insulin treatment. Results: 1 ) There were statistical difference of the highest and lowest of blood glucose levels between CGMS and periphery capillary blood monitoring group. The hypoglycemia rate detected with CGMS was higher than that of periphery capillary blood monitoring group periphery
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