本文選題：2型糖尿病 + 胰島素水平��； 參考：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的研究應(yīng)用胰島素治療的2型糖尿病患者血清胰島素水平升高的影響因素,為2型糖尿病患者提供更加合理化、規(guī)范化及個(gè)體化的治療。方法選取我院(華北理工大學(xué)附屬醫(yī)院)內(nèi)分泌科住院的應(yīng)用胰島素皮下注射降血糖治療的2型糖尿病(T2DM)患者231例,其中男性患者113例,女性患者118例,年齡范圍為24~82歲,平均年齡為(57.62±10.50)歲。根據(jù)血清胰島素水平分為T2DM合并血清胰島素水平升高組(病例組)36例,其中男性13例,女性23例,年齡范圍為39~75歲,平均年齡(58.75±8.70)歲;血清胰島素水平分為T2DM合并血清胰島素水平升高組(病例組)共195例,應(yīng)用SPSS選擇個(gè)案選項(xiàng)隨機(jī)選擇108例,作為1:3對(duì)照,其中男58例、女50例,年齡在26-80歲,平均年齡(56.70±10.97)歲。入組患者均測(cè)定空腹血清胰島素水平(FIns)及餐后2小時(shí)血清胰島素水平(2h Ins),并比較兩組間性別、年齡、身高、體重、體重指數(shù)(BMI)、吸煙及飲酒情況、入院前空腹血糖平均值、入院前胰島素應(yīng)用劑量、應(yīng)用胰島素時(shí)間、出院胰島素用量、糖尿病病程、飲食及運(yùn)動(dòng)情況、血尿酸(UA)、糖化血紅蛋白(Hb A1c)、空腹血糖(FPG)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、空腹血糖(FPG)、餐后2h血糖(2h PG)、空腹C肽(FC-P)、餐后2h C肽(2h C-P)、胰島素抵抗指數(shù)(HOMA-IR)、糖尿病合并癥、高血壓等指標(biāo)。數(shù)據(jù)采用SPSS 21分析,正態(tài)分布計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差((?)±s)表示,兩組間比較采用獨(dú)立樣本t檢驗(yàn);計(jì)數(shù)資料以百分率表示,采用卡方檢驗(yàn);T2DM患者高血清胰島素水平的危險(xiǎn)因素采用非條件二分類logistic回歸模型分析;以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果兩組間性別構(gòu)成、是否糖尿病飲食或運(yùn)動(dòng)構(gòu)成比、吸煙飲酒史構(gòu)成比及有無糖尿病并發(fā)癥構(gòu)成比經(jīng)卡方檢驗(yàn)顯示,兩組間性別構(gòu)成比、吸煙飲酒史構(gòu)成比差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組間是否進(jìn)行糖尿病飲食或運(yùn)動(dòng)控制構(gòu)成比及并發(fā)癥構(gòu)成比差異有統(tǒng)計(jì)學(xué)意義(P0.05),其中血清胰島素水平升高組、飲食運(yùn)動(dòng)占比較低,合并癥占比較高。兩組間入院胰島素用量、TG、UA、FIns、2h Ins、C-P、2h C-P、HOMA-IR經(jīng)t檢驗(yàn)顯示,血清胰島素水平升高組上述指標(biāo)均高于血清胰島素水平正常組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);將卡方檢驗(yàn)及t檢驗(yàn)有統(tǒng)計(jì)學(xué)差異的指標(biāo)作為自變量,以是否出現(xiàn)血清胰島素水平升高為因變量進(jìn)行非條件二分類logistic回歸模型分析,在校正是否進(jìn)行糖尿病飲食或運(yùn)動(dòng)、入院胰島素用量、TG、BMI、UA、C-P、2h C-P、HOMA-IR糖尿病合并癥等因素的影響結(jié)果顯示甘油三酯(OR=2.34)、HOMA-IR(OR=1.21)、2h C-P(OR=1.92)是T2DM合并高胰島素水平的危險(xiǎn)因素,糖尿病飲食或運(yùn)動(dòng)是保護(hù)因素(OR=0.19)。結(jié)論糖尿病飲食或運(yùn)動(dòng)控制欠佳的患者胰島素水平上升的危險(xiǎn)性升高。甘油三酯升高是應(yīng)用胰島素的糖尿病患者胰島素水平升高的影響因素。
[Abstract]:Objective to study the influencing factors of serum insulin level in patients with type 2 diabetes treated with insulin, and to provide more rational, standardized and individualized treatment for type 2 diabetes. Methods 231 patients with type 2 diabetes mellitus (T2DM) treated by hypoglycemic insulin subcutaneous injection were selected from Endocrine Department of North China University of Technology (affiliated Hospital of North China University of Science and Technology). 113 cases were male and 118 cases were female. The age range was 24 ~ 82 years old. The average age was 57.62 鹵10.50 years old. According to the serum insulin level, 36 cases of T2DM with elevated serum insulin level were divided into three groups, including 13 males and 23 females. The age range was 3975 years (mean 58.75 鹵8.70) years. The serum insulin level was divided into two groups: T2DM with elevated serum insulin level (n = 195). 108 cases were randomly selected by SPSS selection as a control group at 1:3, including 58 males and 50 females, aged from 26 to 80 years, with an average age of 56.70 鹵10.97 years. Fasting serum insulin levels (FIns) and 2 hours postprandial serum insulin levels were measured. Sex, age, height, body mass index (BMI), smoking and drinking, fasting blood glucose before admission were compared between the two groups. The dosage of insulin before admission, the time of insulin use, the amount of insulin discharged from hospital, the course of diabetes, diet and exercise, Serum uric acid (UAA), glycosylated hemoglobin (HbA1cN), fasting blood glucose (FPGN), triglyceride (TGN), low density lipoprotein (LDL-C), fasting plasma glucose (FPG), 2 h postprandial glucose (2 h), 2 h postprandial C-peptide (FC-PN), 2 h postprandial C-peptide (FC-PN), insulin resistance index (HOMA-IRN), diabetes mellitus (DM), hypertension and so on. The data were analyzed by SPSS 21, the normal distribution measurement data were expressed as mean 鹵standard deviation) 鹵s, and the two groups were compared by independent sample t test, and the counting data were expressed as percentage. The risk factors of high serum insulin level in patients with T2DM were analyzed by non conditional two classification logistic regression model. Results the sex composition of the two groups, whether diabetes diet or exercise composition ratio, smoking and drinking history ratio and diabetes complications composition ratio by chi-square test showed that the sex composition ratio between the two groups. There was no significant difference in the proportion of smoking and drinking history between the two groups (P 0.05). There was a significant difference in the proportion of diabetic diet or exercise control between the two groups and the ratio of complications. In the group with elevated serum insulin level, the proportion of diet and exercise was lower than that of the control group. Complications are relatively high. The dosage of insulin on admission between the two groups was higher than that in the group with normal serum insulin level, and the results of t test showed that the serum insulin level was higher in the patients with elevated serum insulin level than in the group with normal serum insulin level for 2 h, and the serum insulin level was higher than that in the group with normal serum insulin level for 2 hours. The difference was statistically significant (P 0.05). The independent variables of chi-square test and t test were taken as independent variables, and the non-conditional two-class logistic regression model was used to analyze whether the serum insulin level increased as dependent variable. After adjusting whether to take diabetes diet or exercise, the effect of TGG BMIUAUAUAUAA 2 h C-PHOMA-IR diabetes complication and other factors showed that HOMA-IRO 1.21 h 2 h C-PHOO 1.92) was the risk factor of T2DM with high insulin level, and diabetic diet or exercise was the protective factor. Conclusion Diabetic patients with poor diet or exercise control increased the risk of insulin levels. Elevated triglyceride levels are associated with insulin levels in diabetic patients treated with insulin.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 秦曉凌;田永芳;辛在娥;趙莉;;急性腦梗死患者簡易胰島素抵抗指數(shù)水平的臨床研究[J];中國實(shí)用神經(jīng)疾病雜志;2016年24期

2 周素宏;孫學(xué)麗;;高胰島素血癥飲食治療的研究與效果觀察[J];中國城鄉(xiāng)企業(yè)衛(wèi)生;2016年10期

3 姜帥;;2型糖尿病患者空腹血糖水平與胰島素抵抗、胰島素分泌指數(shù)的相關(guān)性研究[J];按摩與康復(fù)醫(yī)學(xué);2016年17期

4 鐘麗媛;;2型糖尿病胰島素抵抗研究進(jìn)展[J];繼續(xù)醫(yī)學(xué)教育;2016年08期

5 趙俊;隋忠國;辛?xí)袁|;姚文;趙杉杉;曹玉;;腹型肥胖對(duì)成人2型糖尿病患者胰島素抵抗、分泌功能的影響[J];中國生化藥物雜志;2016年07期

6 崔麗娟;馬玲;韓玉;黃麗瑋;楊云花;張曉楠;徐靜;;空腹甘油三酯正常的2型糖尿病患者日常飲食血脂波動(dòng)與胰島素抵抗的相關(guān)性研究[J];中國綜合臨床;2016年07期

7 張雨薇;陳穩(wěn);張馨月;童南偉;;2015年糖尿病重要臨床進(jìn)展回顧[J];中華內(nèi)分泌代謝雜志;2016年06期

8 劉蓓;;阿卡波糖對(duì)初發(fā)2型糖尿病患者臨床療效及胃腸道反應(yīng)的影響[J];醫(yī)學(xué)理論與實(shí)踐;2016年11期

9 宋葉梅;黃昀;鄒朝春;;二甲雙胍對(duì)代謝綜合征患者胰島素敏感性的影響[J];中國現(xiàn)代醫(yī)生;2016年16期

10 曾龍?bào)A;;老年2型糖尿病的藥物治療[J];中華糖尿病雜志;2016年05期

相關(guān)博士學(xué)位論文 前2條

1 張翔;膽汁酸在十二指腸空腸旁路術(shù)改善大鼠T2DM中的作用和機(jī)制研究[D];山東大學(xué);2016年

2 劉兆蘭;中國部分城市地區(qū)2型糖尿病控制研究[D];復(fù)旦大學(xué);2009年

相關(guān)碩士學(xué)位論文 前1條

1 李娟;計(jì)步器聯(lián)合電話支持對(duì)初發(fā)2型糖尿病患者體力活動(dòng)行為改變的效果評(píng)價(jià)[D];中南大學(xué);2014年

，

本文編號(hào)：1841953