Abstract: 【Abstract】〓Objective〓To explore the effect of short-term intensive insulin therapy in patients with hyperglycemia on beta cell function in perioperative period. Methods〓From January 2011 to July 2013 in our hospital, forty-five patients in perioperative period with hyperglycemia were underwent short-term intensive therapy (continuous subcutaneous insulin infusion, CSII group, n=25; multiple subcutaneous insulin injection, MSII group, n=20). The data of FBG, 2hPG, blood glucose GSP, beta cell function and insulin sensitivity index and the changes of TNF-α, IL-1β, CRP and APN were compared between the two groups. Results〓After the treatment, the patients of CSII group and MSII group showed significantly decreased FBG, 2hPG and GSP levels (P<0.05). Both CSII group and MSII group showed significantly lower FCP and Homa-IR levels, and higher Homa-β after treatment (P<0.05). CSII group demonstrated more significantly improvement compared with MSII (P<0.05). And the same changes of TNF-α, IL-1β, CRP, and APN levels were observed after treatment in CSII group compared with MSII group. Conclusion〓The continuous subcutaneous insulin therapy can effectively control blood glucose and improve islet function and insulin sensitivity,which is involved by reducing inflammation.

Key words: Perioperative period, Hyperglycemia, Intensive insulin therapy, Continuous subcutaneous insulin therapy

摘要： 【摘要】 目的 探讨短期胰岛素强化治疗对围手术期高血糖患者β细胞功能的影响。方法回顾性分析2011年1月~2013年7月我院短期胰岛素强化治疗围手术期高血糖的患者临床资料,其中采用持续性皮下胰岛素输注治疗患者25例(CSII组),采用多次皮下胰岛素注射治疗患者20例(MSII组)。治疗2周后,比较两组的血糖控制(FBG、2hPG、GSP)、β细胞功能、胰岛素敏感性指标以及TNF-α、IL-1β、CRP、APN的变化情况。结果〓CSII组与MSII组的FBG、2hPG、GSP水平均较治疗前显著降低,差异具有统计学意义(P<0.05);治疗后CSII组的FBG、2hPG、GSP水平与MSII组比较,差异不显著(P>0.05)。CSII组与MSII组的GSP、Homa-IR水平均较治疗前显著降低,Homa-β较治疗前显著升高,且与MSII组比较改善更显著(P<0.05);同样CSII组TNF-α、IL-1β、CRP水平与MSII组比较也改善更显著(P<0.05)。结论〓持续性皮下胰岛素输注治疗可有效控制血糖,显著改善胰岛β功能及提高胰岛素敏感性,其机制可能与下调炎性因子有关。

关键词: 围手术期, 高血糖, 胰岛素强化治疗, 持续性皮下胰岛素输注