中文摘要：

目的:观察初诊2型糖尿病(T2DM)患者短期胰岛素泵(CSII)强化治疗前后血清超敏C反应蛋白(hs-CRP)的水平,并探讨其变化的影响因素。方法:选取研究对象190例,其中健康对照组70例,初诊T2DM患者120例。T2DM组接受CSII强化治疗2周,比较CSII治疗前后血糖、血脂、胰岛素、稳态模型胰岛β细胞功能指数(HOMA-β)、稳态模型胰岛素抵抗指数(HOMA-IR)、hs-CRP等指标。结果:①初诊T2DM组血清hs-CRP水平2.76(0.81~6.33)mg/L明显高于健康对照组0.48(0.18~0.98)mg/L,差异有统计学意义(P【0.05)。②CSII强化治疗2周后,T2DM组空腹血糖、口服葡萄糖耐量试验(OGTT)2 h血糖(2hPG)、HOMA-IR、hs-CRP水平显著下降,空腹胰岛素(FINS)、HOMA-β明显升高(P【0.01)。③简单相关分析显示治疗前后血清hs-CRP差值(Δhs-CRP)与收缩压差值(ΔSBP)、空腹血糖差值(ΔFPG)、空腹胰岛素差值(ΔFINS)、总胆固醇差值(ΔTC)、低密度脂蛋白差值(ΔLDL-C)、ΔHOMA-IR、ΔHOMA-β呈正相关(r分别为0.287、0.324、0.236、0.257、0.366、0.230、0.201,P均【0.05)。④以Δhs-CRP为因变量,以ΔSBP、ΔFPG、ΔFINS、ΔTC、ΔLDL-C、ΔHOMA-IR、ΔHOMA-β为自变量进行多元逐步回归分析,有ΔFPG(β=0.214,P【0.05)、ΔLDL-C(β=0.263,P【0.05)、ΔFINS(β=0.376,P【0.01)、ΔHOMA-β(β=0.352,P【0.01)、ΔHOMA-IR(β=0.279,P【0.05)进入方程(R2=0.363,P【0.05)。结论:初诊T2DM患者经短期CSII强化治疗后血清hs-CRP水平明显下降,ΔFPG、ΔLDL-C、ΔFINS、ΔHOMA-β、ΔHOMA-IR是影响Δhs-CRP的独立相关因素。

英文摘要：

Objective:To investigate thc changcs of short-term continuous subcutaneous insulin infusion (CSⅡ) on serum hs-CRP levels in patients with newly-diagnosed type 2 diabetes mellitus,and to identify the influencing factors for changes of hs-CRP.Methods:A total of 70 normal controls,120 patients with newly diagnosed type 2 diabetes mellitus were treated with CSⅡ for 2 weeks.Oral glucose tolerance test and insulin releasing test were performed before and after intensive insulin therapy; meanwhile,blood lipid,hsCRP and other parameters were measured.Results:①Serum hs-CRP was significantly higher [2.76 (0.81 ～ 6.33) mg/L] in newly diagnosed type 2 diabetes mellitus than normal controls [0.48 (0.18 ～ 0.98) mg/L].② In the T2DM group,there was a significant decrease in fasting plasma glucose (FPG),2 h plasma glucose (2hPG),HOMA-IR and hs-CRP (P ＜ 0.01 or P ＜ 0.05),a significant increase in homeostasis model assessment for insulin function.③The changes of serum CRP was positively correlated with △ SBP,△FPG,△FINS,△TC,△LDL-C,△HOMA-β,△HOMA-IR (r =0.287,0.324,0.236,0.257,0.366,0.201,0.230,P ＜ 0.05).The multiple regression analysis showed that △FPG(β =0.214,P ＜ 0.05),△FINS(β =0.376,P ＜ 0.01),△LDL-C (β =0.263,P ＜ 0.05),△HOMA-β (β =0.352,P ＜ 0.01),△HOMA-IR(β =0.279,P ＜ 0.05)were independent related factors in the influence of the changes of hsCRP levels.Conclusion:In type 2 diabetic patients,elevated serum hs-CRP levels were significantly decreased after CSⅡ treatment.The multiple regression analysis showed that △FPG,△LDL-C,△FINS,△HOMA-β and △HOMA-IR were independent related factors in the influence of the changes of hs-CRP levels.