肝病患者胰高血糖素、糖化血红蛋白检测及胰岛素和C肽释放试验的临床意义

Clinical Signification of the C-peptide and Insulin Release Tests and Detection of Glycosylated Hemoglobin and Pancreatic Glucagon in Patients with Liver Diseases

目的:探讨肝病患者糖代谢紊乱与糖尿病之间的鉴别诊断及临床意义。方法:应用放射免疫法研究46例肝病患者和39例糖尿病患者的(?)高血糖素(IRG)、糖化血红蛋白(GHb)及胰岛素(IRI)和C肽释放试验。结果:慢性肝炎肝硬变、肝原性糖尿病、糖尿病有不同程度的高IRG血症,各型糖尿病有不同程度的高GHb血症。胰岛素和C肽释放试验:慢性肝炎肝硬变呈高峰延迟型,肝原性糖尿病呈高反应型,普通糖尿病呈低反应型,它们之间有极显著性差异,结论:高糖化血红蛋白血症与血管并发症的发生有一定关系。高胰高血糖素血症是糖尿病原发的、始动的发病因素。利用胰岛素和C肽释放试验,对慢性肝炎肝硬变的糖代谢紊乱、肝原性糖尿病、胰岛素依赖型糖尿病、非胰岛素依赖型糖尿病可进行鉴别诊断,有助于临床药物的应用。

Aim: To study clinical signification of the C-peptide and insulin release tests and detection of glycosylated hemoglobin (GHb) and pancreatic glucagon in chronic hepatitis and hepa-tocirrhosis. Method: The C-peptide and insulin release tests and pancreatic glucagon and GHb were studied used by radioimmunossay in 46 patients with chronic hepatitis and cirrhosis and 39 patients with diabetes. Result: The C-peptide and insulin release tests: Chronic hepatitis and cirrhosis present height postponement type. Diabetes presents lower reaction type. Hepatogenous diabetes present higher reaction type. Chronic hepatitis and cirrhosis present higher serum pancreatic glucagon. Conclusion: The C-peptide and insulin release tests was helpful differential diagnosis in IDDM, NIDDM and hepatogenous diabetes. Higher serum GHb of hepatogenous diabtes cause structure change and function disorder in blood tubes. The hyperglucagon of chronic hepatitis and cirrhosis cause original factor of diabetes.