自体造血干细胞移植对1型糖尿病患者血糖控制作用的对照研究

摘要

Objective To compare autologous stem cell transplantation and insulin action glycemic control in patients with type 1 diabetes. Methods A total of 40 patients with newly diagnosed type 1 diabetes patients were divided into transplantation group of 15 patients and 25 cases of insulin groups accorded to treatment, transplantation group treated with autologous hematopoietic stem cell transplantation, insulin group with conventional insulin injection therapy, fol-low-up of > 12 months, 12 months after treatment the adoption of continuous glucose monitoring and evaluation of glycemic control was evaluated. Results Transplantation group after treatment, MBG, LAGE were significantly lower than before treatment (P<0.05), after treatment, transplantation group MBG, SDBG, LAGE, MAGE were significantly lower than insulin group (P<0.05). After the transplant group therapy significantly reduced HbA1c compared with be-fore treatment and significantly lower than in the insulin group(P<0.05), group 2 patients transplanted insulin were de-activated in 9.3,11.2 months, an average reduction of insulin (53.28±21.29)%, after treatment, the amount of insulin significantly reduced transplant group and significantly lower than the insulin group (P<0.05), post-transplant group therapy blood glucose <3.9 mmol/L percentage of time, blood glucose > 11.1 mmol/L percentage of time were signifi-cantly lower than before treatment, and significantly lower than insulin, glucose (3.9~11.1) mmol/L percentage of time increase in the percentage of time now compared to before treatment, and significantly higher than that in the insulin group (P<0.05). All patients with severe adverse reactions occur. Conclusion Compared to conventional insulin injec-tion therapy, autologous hematopoietic stem cell transplantation can effectively control blood sugar with type 1 diabetes, can reduce blood sugar fluctuations, reduce insulin dependence.%目的：对比自体造血干细胞移植和胰岛素对1型糖尿病患者血糖控制作用。方法将40例初发1型糖尿病患者根据治疗方法分为移植组15例和胰岛素组25例，移植组采用自体造血干细胞移植治疗，胰岛素组采用常规胰岛素注射治疗，随访>12个月，治疗12个月后采用动态血糖监测评价血糖控制情况。结果移植组治疗后MBG、LAGE均显著低于治疗前(P<0.05)，治疗后移植组MBG、SDBG、LAGE、MAGE均显著低于胰岛素组(P<0.05)。移植组治疗后HbA1c较治疗前显著降低并显著低于胰岛素组(P<0.05)，移植组2例分别在9.3、11.2个月时停用胰岛素，胰岛素平均减量(53.28±21.29)%，移植组治疗后胰岛素用量显著降低并显著低于胰岛素组(P<0.05)，移植组治疗后血糖<3.9 mmol/L时间百分比，血糖>11.1 mmol/L时间百分比均较治疗前显著降低，并显著低于胰岛素组，血糖(3.9~11.1)mmol/L时间百分比较治疗前显著增加，并显著高于胰岛素组(P<0.05)。所有患者未出现严重不良反应。结论相比传统胰岛素注射治疗，自体造血干细胞移植能有效控制1型糖尿病患者血糖，可降低血糖波动，减少胰岛素依赖。