非糖刺激试验评价胰岛β细胞功能的临床应用

Clinical Application of Non-glucose Stimulating Test in the Evaluation of Pancreatic β-cell Functions

目的探讨精氨酸刺激试验(AST)和胰高血糖素刺激试验(GST)在糖尿病病人的年龄、病程和体重指数(BMI)等不同的情况下评价胰岛β细胞功能的价值,以指导临床合理评价胰岛β细胞功能。方法60例2型糖尿病(T2DM)患者分成A、B两组及不同亚组,采用自身对照及交叉试验方法,分别测定血糖、精氨酸(Arg)刺激后3min、胰高血糖素(Glg)刺激后6min的C肽释放水平并作比较。结果A、B两组注射Arg、Glg后血压、血糖均无明显升高(P>0.05),各组比较精氨酸刺激后3minC肽与胰高血糖素刺激后6minC肽差异均无统计学意义(P>0.05),且存在正相关(P均<0.05)。结论AST、GST相对于口服糖耐量试验对DM患者是有利的;胰岛β细胞对Arg和Glg这两种非葡萄糖刺激物的反应程度相似,而且两试验结果的相关性良好,对临床合理选用评价胰岛β细胞功能的方法有一定的参考价值。

Objective To evaluate the applicability of AST and GST tests in the monitoring of pancreatic β cell functions in diabetic patients of different age, disease duration and BMI （body mass index）. Method 60 patients were randomly divided into two groups： A and B. Levels of plasma glucose and arginine （Arg） were measured at 3 minutes after glueagon （Gig） stimulation. The release of C-peptide was determined at 6 minutes after glueagon stimulation. Result The levels of plasma glucose in group A and B patients were not changed after non-glucose stimulation （P〉0.05）. The levels of Arg and C-peptide were also not changed in all patients before and after stimulation （P〉0.05）. Conclusion AST and GST are better than OGDD for DM patients. The response of pancreatic β cells to the two non-glucose stimuli Arg and Glg was similar. Both AST and GST are suitable in clinical evaluation of the pancreatic β cell functions.