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目的：观察胰岛素泵治疗对老年2型糖尿病患者血清同型半胱氨酸（Hcy）水平的影响，并探讨其变化与胰岛素抵抗的相关性。方法：选取正常糖耐量者（NGT）47例，老年T2DM患者46例，T2DM组治疗前后检测血糖，血脂，血清Hcy等相关代谢指标。结果：①T2DM组血清Hcy水平（12.30±4.17）μmol/L明显高于NGT组（9.42±2.13）μmol/L，差异有统计学意义（t=2.130,p<0.05）。②T2DM组经CSII治疗2周后空腹血糖（FPG）及餐后2h血糖（2hPG）均明显下降，差异均有统计学意义（p<0.01）。同时稳态模型评估的胰岛素抵抗指数(HOMA-IR)显著下降。血清Hcy水平显著下降，差异有统计学意义（t=2.374,p<0.05）。③Pearson相关分析显示，T2DM组血清Hcy水平与HOMA-IR呈正相关（r=0.342,p<0.05）。④多元逐步回归分析显示HOMA-IR是影响血清Hcy的独立相关因素。结论：老年T2DM患者经短期CSI治疗后胰岛素抵抗明显改善，同时血清Hcy水平显著下降，HOMA-IR与呈血清Hcy水平呈正相关。“,”Objective:To observe the 1evel of and to observe the effect of short-term continuous subcutaneous insulin infusion(CSI )on Hcy in T2DM,and to investigate the association between insulin resistance and Hcy.Methods:45 cases as NGT group and 45 T2DM patients were involved in this study.The T2DM patients were treated with CSI for 2 week.Before and after CSI therapy,75 g oral glucose tolerance test(OGTT) were performed.The level of plasma glucose and insulin were examined respectively,serum Hcy and other items were also measured.Results:① Serum Hcy levels in the T2DM group(12.30±4.17)μmol/L were higher than the NGT group(9.42±2.13)μmol/L(t=2.130,p<0.05).② In the T2DM group,there was a significant decrease in fasting plasma glucose(FPG)and 2 h plasma glucose after glucose overload (2hPG)(P <0.01),a significant decrease in homeostasis model assessment for insulin resistance(HOMA-IR)values[2.00(1.34~2.62)vs1.31(0.91~1.80)],serum Hcy concentrations were significantly decreased(t=2.374,p<0.05)after CSI treatment for 2 weeks.③In the T2DM group,serum Hcy levels positively correlated with HOMA-IR(r=0.342,p<0.05).④ The multiple regression analysis showed that HOMA-IR was an independent related factor in the influence of the Hcy concentrations.Conclusion:In the T2DM group insulin resistance was improved and serum Hcy concentrations were significantly decreased after two weeks CSI treatment.The levels of Hcy were positively associated with insulin resistance.