摘要
目的:探讨胰岛素(Ins)治疗的适宜方案。方法:雄性家兔40只,随机分成对照组(N组)、糖尿病模型组(D组)、多次Ins治疗组(A组)、50R混合Ins治疗组(B组)、30R混合Ins治疗组(C组)。治疗组用Ins30d后处死动物,同时处死其他组动物;观察各治疗组血糖达标时间及达标时Ins用量。比较各组血糖、糖化血红蛋白(HbA1c)、白天平均血糖水平(MBG)、血糖标准差平均值(MOS)、每只兔血糖绝对差值的平均值(MODD)、肿瘤坏死因子-α(TNF-α)、细胞外基质部分成分(ECM)、NF-κB的表达。结果:A组达标时间最短,C组最长(P<0.01)。治疗组血糖、HbAlc较D组下降(P<005)。A、D两组较C、N组NF-κB灰度值明显降低,TNF-α、ECM明显升高(P<0.05)。A组MOS、MODD较C组N组明显升高(P<0.001);HbA1c与MBG呈正相关(P<0.001)、与MOS、MODD无相关。D组血糖与NF-κB灰度值、HWI呈负相关、与TNF-α呈正相关(均P<0.02)。心脏炎症因子表达明显度D组>A组>B组>C组。结论:较高的基础Ins浓度的30R混合Ins治疗方案最佳。Ins3短加1中或长的强化治疗及太短时间达标的方法不主张首选。
Objective To explore the optimal insulin regimens for diabetes mellitus. Methods Fourty male rabbits were randomly divided into group N （control）, group D （diabetic model）, group A （multiple injections of insulin）, group B （premixed 50R insulin）, and group C （premixed 30R insulin）. All the rabbits were sacrificed on day 30. The time to reach the target blood glucose level and the dosage of insulin were recorded in 3 insulin groups. Blood levels of glucose,HbA1c, daytime mean blood glucose （MBG）, blood glucose mean of standard deviation （MOS）, blood glucose mean of definite difference （MODD） for each rabbit, and TNF-α were compared. Extracellular matrix （ECM） and NF-κB expressed were detected. Results The The time to reach the target blood glucose level was the shortest in group A and the longest in group C（P 0 01）. Levels of blood glucose and HbAlc were lower in the insulin groups than in group D. The NF-κB grayscale values were significantly lower while TNF-α and ECM were markedly higher in groups A and D than in groups C and N （P 0.05 for both comparisons）; MOS and MODD were significantly higher in group A than in groups C and N （P 0.001）. HbA1c was positively correlated with MBG（P 0.001）. In group D, blood glucose level was negatively related to HWI and NF-κB grayscale but positively related with TNF-α（P 0.02）. The expression level of inflammatory factors was the highest in group D, followed by groupA, then B and last C. Conclusions Therapy with premixed 30R insulin is the optimal treatment for diabetes. Therapies with three short-acting agents plus one intermediate- or long-acting agent or therapy for reaching the target blood glucose level too quickly should not be used as a primary regimen.
出处
《实用医学杂志》
CAS
北大核心
2010年第18期3296-3298,共3页
The Journal of Practical Medicine
基金
广西科学基金(编号:桂科基0385005)
