精氨酸指数正常值的建立

Establishment of Normal Reference Range of Arginine Index

目的该研究在糖耐量正常人群中分别采用化学发光法及放射免疫法测定空腹及精氨酸（Arg）刺激后各点血清胰岛素（Ins）、C肽（Cp）水平的变化,并建立精氨酸指数（AIR-Arg）的正常参考值,为临床的应用提供依据.方法70名居住在上海地区的汉族人（男22名/女48名,年龄22-55岁）.分别采用化学发光法及放射免疫法测定Arg刺激后0、2、4、6min血清Ins、Cp水平,以Arg刺激后Ins、Cp增值（AIR）反映β细胞快速分泌功能,将NGT者AIR-Ins、AIR-Cp的下1/4位点作为正常参考值.结果①Arg刺激后正常糖耐量者的Ins、CP水平迅速升高,在2-4min内分泌达到高峰,随即迅速下降.血糖则表现出轻度升高,与前两者上升趋势不平行.②分别用化学发光法及放射免疫法测定的正常人AIR参考值：AIR-Ins（化学发光法）≥24.07mU/L,AIR-Cp（化学发光法）≥2.1ng/mL及AIR-Ins（放射免疫法）≥30.94mU/L,AIR-Cp （放射免疫法）≥1.9ng/mL,呈非正态分布.③用两种方法测定的AIR-Ins、AIR-Cp呈显著正相关.结论 AIR-Arg可作为胰岛快速分泌相的指标,反映胰岛β细胞功能的异常与否.测定的正常人AIR-Arg结果可作为该实验室的正常参考值,为临床评估提供依据.

Objective To perform arginine stimulation test in subjects with normal glucose tolerance and measure plasma insulin and C-peptide level with chemiluminescence method and radioimmunoassay,respectively to establish the normal reference range of Arginine index.Methods Arginine stimulation test were performed in 70 individuals（men/women：22/48,age：22-55） who participated a physical examination in our hospital. Serum true insulin and C-peptide were measured at fasting and 2,4,6 minutes after injection of arginine with chemoluminescence method and radioimmunoassay,respectively and arginine index was calculated.Results ①The reference range of arginine index（true insulin secretion and C-peptide secretion） was more than 24.07mU/L and 2.1ng/mL（chemiluminescence method）,30.94mU/L and 1.9ng/mL（radioimmunoassay）,respectively,the range was normal distribution.②After 2-4 minutes injection of arginine,true insulin and C-peptide secretion reached the peak and decreased immediately.The blood glucose levels raised slightly and was not paralleled to elevate true insulin and C-peptide.③The result of true insulin and C-peptide measured with chemoluminescence method and radioimmunoassay were significantly correlated.Conclusion The arginine stimulation test enable estimateβcell secretory capacity.Arginine index could be used as reliable parameters in evaluating the early phase insulin secretion.