【摘要】 目的 探討預混門冬胰島素對2型糖尿病（type 2 diabetes mellitus，T2DM）患者血漿成纖維細胞生長因子-21（fibroblast growth factor-21，FGF-21）水平的影響。 方法 2008年2—12月采用酶聯免疫吸附試驗測定44例正常人及37例采用預混門冬胰島素治療前后的T2DM患者的血漿FGF-21水平，分析血漿FGF-21水平與體質量指數（body mass index，BMI）、體內脂肪百分比（FAT%）、腰臀比、血脂、血糖、糖化血紅蛋白（hemoglobin A1c， HbA1c）、游離脂肪酸（free fatty acid，FFA）等的關系。 結果 治療前T2DM組患者血漿FGF-21[（1.79±0.04） μg/L]水平明顯高于正常對照組[（1.35± 0.21） μg/L]，差異有統計學意義（Plt;0.01）。T2DM組經16周預混人胰島素類似物（BIAsp 50和BIAsp 30）治療后FFA、HbA1c、空腹血糖、餐后2 h血糖均降低（Plt;0.01），空腹血漿FGF-21水平降低至（1.33±0.39） μg/L，與治療前比較差異有統計學意義（Plt;0.01）。相關分析發現T2DM組患者血漿FGF-21水平與BMI呈正相關（r=0.53，Plt;0.01），BMI是影響T2DM患者血漿FGF-21水平的獨立相關因素。 結論 預混人胰島素類似物能有效改善T2DM患者代謝紊亂，同時能顯著降低FGF-21水平。【Abstract】 Objective To investigate the effects of treatment with aspart insulin on plasma fibroblast growth factor-21 (FGF-21) levels in patients with type 2 diabetes mellitus (T2DM). Methods From February to December 2008, plasma FGF-21 levels were measured by enzyme-linked immunosorbent assay in 37 patients with T2DM treated with aspart insulin and 44 normal controls. The relationship between plasma FGF-21 levels and body mass index (BMI), percentage of body fat (FAT%), waist-hip ratio (WHR), blood lipid, blood glucose, hemoglobin A1c (HbA1c), and free fatty acid (FFA) was analyzed. Results Before treatment, plasma FGF-21 level was significantly higher in T2DM patients [(1.79±0.04) μg/L] than that in the normal controls [(1.35±0.21) μg/L] (Plt;0.01). After 16 weeks of treatment with premixed human insulin analogues (BIAsp 50 and BIAsp 30), FFA, HbA1c, fasting plasma glucose and 2-hour postprandial blood glucose decreased significantly (Plt;0.01), and fasting plasma FGF-21 level decreased to (1.33±0.39) μg/L which was significantly different from that before treatment (Plt;0.01). Correlation analysis showed that plasma FGF-21 level was positively correlated with BMI (r=0.53,Plt;0.01), which was an independent factor in influencing the FGF-21 level in the patients. Conclusion Aspart insulin treatment can remarkably improve glucose metabolism and significantly decrease the fasting plasma FGF-21 level.