胰岛素发展史及分类.ppt

而且诺和笔? 5用于诺和诺德全线的胰岛素产品，方便及时调整治疗方案 * * * * * 全球胰岛素的发展史是：人胰岛素到类似物，预混单一比例到多比例的过程。从1922年第一支动物胰岛素的出现到现在，胰岛素的研发已经历了三个时代。 动物胰岛素是1代胰岛素，人胰岛素是2代胰岛素，而胰岛素类似物是3代胰岛素，每一代胰岛素的更新和推出都是满足了糖尿病治疗不断提高的临床需求。 之前，诺和诺德公司在中国上市的第三代胰岛素类似物包括速效胰岛素类似物诺和锐、预混胰岛素类似物诺和锐30、基础胰岛素类似物诺和平，2012年高比例预混胰岛素类似物-双时相门冬胰岛素50也来到了中国。 In 1921, Canadian surgeon Banting assisted by medical student Best started working on the extraction of insulin from the pancreas of dogs. They were successful in proving that the extract could lower blood glucose in dogs. After improving the extraction procedure the team obtained more pure and potent extracts with hypoglycaemic action. In January 1922 the first injection of insulin was given to a 14-year-old boy. The first person with diabetes was treated with insulin in January 1922. It was a 14-year-old boy, Leonard Thompson. He was in the wards of Toronto General Hospital and had diabetes since December 1919. He was very weak and was not expected to live much longer. On 11 January he was given the first injection of pancreatic extract. There was no discernible clinical benefit from this injection. Injections were given between 23 January and 4 February resulting in obvious improvements. Urine glucose fell, ketone bodies disappeared from the urine, ...the boy became brighter, more active, looked better and said he felt stronger. When the administration of extract was discontinued, all the symptoms and findings recurred. Hence, the first person with diabetes was saved from the clutches of death. With the advent of insulin, Leonard lived till 1935. * 不管技术水平如何先进、纯度多高，“动物胰岛素”与人体内自然产生的“人胰岛素”在氨基酸结构上存在着差异。因此，由于其免疫原性导致的胰岛素抗体产生导致不能理想控制血糖、注射局部硬结、“胰岛素过敏反应”和胰岛素介导的皮肤反应等副作用无法消除。 80年代人类基因重组技术出现，制造出大量高纯度的合成人胰岛素，动物胰岛素时代因此结束。人胰岛素的使用避免了动物胰岛素的诸多副作用，为临床治疗带来了更好的选择。 * 诺和灵R，模拟生理性胰岛素分泌，有效控制餐后血糖，是唯一SFDA批准可用于静脉注射的常规人胰岛素。可用于基础+餐时给药方案。 在这个治疗方案中，餐时胰岛素使用的是常规短效胰岛素。基础胰岛素可以每日1次或2次注射以满足对基础胰岛素的需求。从图中可以看到，这种治疗方案所获得的循环胰岛素水平与生理胰岛素分泌非常接近。 * 但人胰岛素也有其局限性。首先来看常规短效人胰岛素的不足。大家看这两条曲线，蓝色的是正餐人进餐后分泌的餐时胰岛素高峰，而黄色曲线是皮下注射人胰岛素后形成的曲线，