TNF-α对短期胰岛素强化治疗诱导短病程2型糖尿病长期缓解的预测作用

关键词：2型糖尿病  肿瘤坏死因子α  胰岛素强化治疗  长期缓解

Keywords:type 2 diabetes  tumor necrosis factor  intensive insulin treatment  long-term remission

摘要：

      目的：研究短病程2型糖尿病患者经短期胰岛素强化治疗获长期缓解的预测因素。方法：入选36例病程不超过半年的初诊2型糖尿病患者，给以2周的胰岛素强化治疗。强化治疗前及结束24h后分别进行标准餐试验和静脉葡萄糖耐量试验。治疗后不用任何降糖药物血糖能良好控制1年视为长期缓解。 结果：长期缓解率为80.6%（29/36）。缓解组基线TNF-α水平（1.86±1.90ng/L，n=29）强化治疗后降至1.39±2.18ng/L，P<0.001。未缓解组（n=7）TNF-α水平无显著降低。△TNF-α（基线-治疗后）水

Abstract:

      Objective: To investigate the predictors for the long-term remission of type 2 diabetes of short course induced by means of short-term intensive insulin treatment. Method: 36 cases of diabetic patients with high level of hyperglycemia and duration no more than 0.5 year received the two-week long intensive insulin treatment. Remission meant that the diabetic patients should maintain the desired glycaemic control without any hypoglycaemic agents within one year. Result: The remission rate was up to 80.6% (29/36). The TNF-α at baseline in remission group was 1.86±1.90ng/L(n=29), and the level after intensive treatment decreased to 1.39±2.18ng/L，P<0.001. No significant decrease was observed in non-remission group(n=7). △TNF-α level (at baseline minus that after treatment) was positively correlated with the long-term remission event in Spearman analysis, r=0.428, P=0.010. Conclusion: The long-term remission can be induced in most newly-diagnosed type 2 diabetic patients. △TNF-α is the most important predictor for the long-term remission event.