冠心病心衰患者胰岛糖代谢调节激素变化

Changes of glycoregulatory hormone secreted by islets of Langerhans in patients with heart failure of coronary heart disease

目的 :了解胰岛糖代谢调节激素的变化与冠心病心力衰竭 (HFCHD)发生、发展的关系。方法 :分别测定47例HFCHD患者治疗前、后及正常对照组空腹血糖 (Glu)、胰岛素 (In)、胰高血糖素 (Gc)、C肽 (Cp)水平。结果 :(1)各组间Glu均无显著差异 (P >0 0 5 ) ;(2 )HFCHD患者In、Gc均高于正常对照组 (P <0 0 5 ) ;HFCHD患者心功能越差 ,血浆In、Gc水平越高 ,治疗后均有所改善 ,尤以心功能Ⅲ、Ⅳ级组差异显著 (P <0 0 5 ) ;(3)HFCHD患者Cp水平亦显著高于正常对照组 (P <0 0 5 ) ,但不同心功能各组间无显著性差异 (P >0 0 5 )。结论 :(1)HFCHD患者存在高In血症和高Gc血症。 (2 )

Objective:To explore the relationship between the changes of glycoregulatory hormone secreted by islets of Langerhans and the occurrance and development of heart failure of coronary heart disease (HFCHD). Methods:Fasting plasma levels of glucose, insulin, glucagon and C peptide were measured in 47 patients with HFCHD and in normal control group, respectively, before and after their treatment.Results: (1) There were no significant differences in glucose levels among all groups( P >0 05); (2) Insulin and glucagon in patients with HFCHD were higher than those in the control group ( P <0 05). And the worse the cardiac function, the higher the plasma insulin and glucagon levels. However, they were all improved after the treatment, particularly in patients with cardiac function grade Ⅲ and Ⅳ ( P <0 05); (3) Although the C peptide levels in patients with HFCHD were higher than those in the control group ( P <0 05), there were no significant differences among different groups in cardiac function ( P >0 05). Conclusion:(1)The patients with HFCHD have hyperinsulinemia and hyperglucagonemia; (2)The patients with HFCHD are less sensitive to insulin and glucagon at the same time.