【摘要】 目的 探讨预混门冬胰岛素对2型糖尿病（type 2 diabetes mellitus，T2DM）患者血浆成纤维细胞生长因子-21（fibroblast growth factor-21，FGF-21）水平的影响。 方法 2008年2—12月采用酶联免疫吸附试验测定44例正常人及37例采用预混门冬胰岛素治疗前后的T2DM患者的血浆FGF-21水平，分析血浆FGF-21水平与体质量指数（body mass index，BMI）、体内脂肪百分比（FAT%）、腰臀比、血脂、血糖、糖化血红蛋白（hemoglobin A1c， HbA1c）、游离脂肪酸（free fatty acid，FFA）等的关系。 结果 治疗前T2DM组患者血浆FGF-21[（1.79±0.04） μg/L]水平明显高于正常对照组[（1.35± 0.21） μg/L]，差异有统计学意义（Plt;0.01）。T2DM组经16周预混人胰岛素类似物（BIAsp 50和BIAsp 30）治疗后FFA、HbA1c、空腹血糖、餐后2 h血糖均降低（Plt;0.01），空腹血浆FGF-21水平降低至（1.33±0.39） μg/L，与治疗前比较差异有统计学意义（Plt;0.01）。相关分析发现T2DM组患者血浆FGF-21水平与BMI呈正相关（r=0.53，Plt;0.01），BMI是影响T2DM患者血浆FGF-21水平的独立相关因素。 结论 预混人胰岛素类似物能有效改善T2DM患者代谢紊乱，同时能显著降低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.