糖尿病患者经不同降糖方案治疗后血清Visfatin、Ghrelin及CA19-9水平的变化

摘要

目的 了解糖尿病患者口服阿卡波糖、皮下胰岛素注射、持续皮下胰岛素泵治疗后血清Visfatin、Ghrelin及CA19-9水平的变化及其与相关代谢指标的关系.方法将90名糖尿病患者根据不同降糖方案分为3组:A组为口服阿卡波糖组(n=30),B组为常规多次胰岛素皮下注射组(n=30),C组为胰岛素泵持续皮下输注组(n=30),测定治疗前后生化指标及血清中Visfatin、Ghrelin及CA19-9水平.结果①3组患者治疗后血清Visfatin、CA19-9水平降低(P<0.05);血清Ghrelin水平增高(P<0.05);②治疗后血清Visfatin的下降值与WC、WHR以及TG、LDL-C、FBG的下降值呈正相关;血清CA19-9的下降值及Ghrelin的上升值与TC的下降值有相关性;③C组血清Visfatin、Ghrelin以及TG、TC和FBG的下降程度较A组和(或)B组显著(P<0.05).结论口服阿卡波糖、常规多次胰岛素皮下注射及胰岛素泵持续皮下输注均可以一定程度上改善糖尿病患者糖脂代谢,有利糖尿病病情的缓解.%Objective To investigate the changes of the serum levels of Visfatin,Ghrelin,CA19-9 and their relationships to relative metabolism parameters after different treatments of diabetes mellitus. Methods Ninety diabetic mellitus cases were treated for 3 months or 7 days and divided into three groups.The subjects in group A received acarbose .The subjects in group B were treated with conventional subcutaneous insulin lispro injection for several times .The subjects in group C were treated with continuous subcutaneous insulin infusion pump. The 1evels of Visfatin, Ghrelin, CA19-9 were measured before and after treatment. Results ①After treatment, the serum Visfatin, CA19-9 levels of three groups of patients were decreased significantly (P< 0.05), and the serum Ghrelin levels increased significantly (P< 0.05). ② The decrement of the serum Visfatin levels( △Visfatin) was positively correlated with waist circumference(WC), WHR and the decrement of levels of TG, LDL, FBG. ③ The decrement of the serum CA19-9 and the increment of the serum Ghrelin 1evels were correlated with the decrement of levels of TC. ④ The decrement of the serum Visfatin, TG, TC, FBG and the increment of the serum Ghrelin in group C was more than that in group A and (or) group B. Conclusion Acarbose, MDI and CS II can improve gluco-lipid metabolism in patients with diabetes mellitus and play important role in the remission of diabetes mellitus.