葡萄糖负荷下胰岛素、C-肽及胰高血糖素释放试验判断胰岛细胞功能的临床探讨

A clinical research on judgment of the function of insulin cells through the tests of insulin,C-peptide and glucagon release under the load of glucose

目的 依据糖尿病病人胰岛素、C 肽及胰高血糖素释放试验的数值和糖耐量试验的数值 ,进行综合判断 ,对胰岛细胞功能受损和胰岛素抵抗的程度进行初步研究。方法 采用放射免疫分析方法测定胰岛素、C 肽和胰高血糖素。结果 ( 1)胰岛素释放试验 ,除胰岛 β细胞轻度受损组的空腹及 1h正常对照差别无显著性 (P <0 .0 5 )外 ;其余均有高度显著性差别 (P <0 .0 1)。 ( 2 )C 肽释放试验 ,轻度受损组和中度受损组 1h均低于正常对照组 (P <0 .0 1) ;而 2、3h均高于正常对照组 (P <0 .0 1) ;重度受损组 1、2、3h均低于正常对照组 (P <0 .0 1)。 ( 3)胰高血糖释放试验 ,轻度受损组 ,空腹 1、2、3h均低于正常组 (P <0 .0 1) ;中度受损组 1、2、3h均高于正常组 (P <0 .0 1) ;而重度受损组则无差异 (P >0 .0 5 )。( 4 )糖耐量试验 ,轻度受损组与正常组相比 ,空腹 1、2、3h均增高 (P <0 .0 1)。结论 依据糖尿病人胰岛素、C 肽及胰高血糖素释放试验的数值和糖耐量数值 ,可以判断胰岛细胞功能受损程度。

Objective Through the diabetics;insulin,C peptide release test and OGTT,on the bases of general judgement,we made the preliminary research on damaged insulin cells as well as insulin.Methods We determined the result of insulin C peptide using the method of radioactive immunity analysis.Results (1)The result of the insulin release test.Except that the patients whose insulin cells are slightly damaged had no remarkable difference(P>0.05)in the condition of empty stomach and 1h ,others have remarkable difference(P<0.01).(2)The result of C peptide release test:For slightly and mediumly damaged persons,1 h is remarkably lower than that of the normal group (P<0.05).and 2 h,3 h are all higher than that of the normal group(P<0.01).For seriously glucagon damaged persons,1,2,3 h are all remarbably lower than that of the normal group.(3)The result of PG release test:for slightly damaged persons,1,2,3 h are all remarkably lower than that of the normal group (P<0.01).For medium damaged perscns,1,2,3 h are all remarkably than that of higher the normal group (P<0.01).For seriously damaged persons,1,2,3 h have no difference (P>0.05) compared with that of the normal group.(4)OGTT test:for slightly damaged persons of empty stomach and 1,2,3 h are remarkably higher than that of the normal group (P<0.05),while for medium damaged and serious damaged groups 1,2,3 h are remarkably higher than that of the normal group.Conclusion Thrugh the diabetics insulin C petide relsase test and OGTT,can judge to damaged insulin cells as well as insulin.