63例肾综合征出血热患者胰岛β细胞储备功能的临床研究

A CLINICAL STUDY ON RESERVE CAPACITY OF ISLET β CELLS IN 63 PATIENTS WITH HEMORRHAGIC FEVER OF NEPHROTIC SYNDROME

目的 探讨肾综合征出血热 ( HFRS)患者胰岛β细胞的储备功能 ,为临床治疗该病的用药提供依据。方法 对 63例患者进行了静脉法糖耐量试验 ,并同时检测了血清各时相 C肽和胰岛素水平。结果 糖负荷后血清 C肽峰值仅为基值的 2 .9倍 ,30、60 min血清 C肽水平均显著低于对照组 ( P <0 .0 1 )。血清胰岛素与 C肽水平相平行 ,糖负荷后 34.9%的患者出现胰岛素低平曲线。此外 ,随病情加重 ,胰岛 β细胞储备功能减退更为显著 ,糖代谢紊乱程度亦愈加明显。结论 HFRS患者存在胰岛 β细胞储备功能不足。及时检测血糖 ,酌情加用适量胰岛素对病人可能有利。

Objective To explore the reserve capacity of islet β cells in patients with hemorrhagic fever of nephrotic syndrome (HFRS) in order to provide information about clinical drug application.Methods Intravenous glucose tolerance tests were carried out in 63 cases of HFRS and the levels of c peptide and insulin of these cases at different stages were measured.Results The maximum level of c peptide after the test was only 1.9 times higher than the baseline level.The levels at the 30th minute and 60th minute were lower than those in the control group(P<0.01).The level of serum insulin was parallel to that of c peptide,and a low flat curve of insulin level was found among 34.9% of the cases after the test.As patients' conditions became severe,the reserve capacity of islet β cells decreased and the dysfunction of sugar metabolism grew serious.Conclusion The reserve capacity of islet cells in patients with HFRS is insufficient and immediate determination of glucose and adequate application of insulin would be benificial to patients with HFRS.