胰升糖素试验在评价2型糖尿病病人胰腺β细胞功能中的作用

Assessment of residual beta-cell function using the glucagon test in type 2 diabetic patients

目的 探讨胰升糖素试验在评价 2型糖尿病 (T2 DM)病人胰腺 β细胞功能中的作用。 方法 T2 DM病人 1 5 0例 ,空腹血浆血糖浓度 (FPG)大于 7.0 mm ol/ L。隔夜空腹取血测定 FPG、空腹血清 C肽 (C肽 1 ) ,静脉注射胰升糖素 1 m g,注射时间 1 m in,注射后 6 min取血测定血清 C肽 (C肽 2 )。计算前后差值 (Δ C肽 =C肽 2 - C肽 1 )。注射前后测定患者血压、脉搏 ,记录不良反应。 结果 T2 DM病人注射胰升糖素后血清 C肽均升高。空腹 C肽与注射胰升糖素 6 m in后 C肽呈正相关 (P<0 .0 5 ) ,基础和刺激后 C肽浓度与 BMI呈显著正相关 (P<0 .0 5 )。 ΔC肽与空腹 C肽 (P<0 .0 5 )、注射后 C肽 (P<0 .0 1 )呈正相关 ,与病程呈负相关 (P<0 .0 5 )。血糖控制差组 (Hb A1 c≥ 7.0 % ,n=86 )与血糖控制好组 (Hb A1 c<7.0 % ,n=6 4 )相比 ,基础 C肽差异无显著意义 ,而刺激后 C肽和 C肽增加绝对值 ,血糖控制好组高于血糖控制差组 (P<0 .0 5 )。 结论 胰升糖素试验是一种判定胰腺 β细胞功能的较为简单、可靠。

Objective To invest ingats the role of the glucagon test in evaluating the residual B cell function in Type 2 DM. Methods 150 type 2 diabetic patients were enrolled. A glucagon test was performed in overnight fasting. Blood samples were collected at 0 and 6 min after i.v. glucogan injection. Plasma C peptide concentration, HbA 1c, FPG, blood pressure and pulse were measured before and after the test. Results In type 2 DM, serum C peptide levels were all increased after glucogan injection. And it was positively correlated with basal serum C peptide level( P < 0.05). C pepetide levels before and after injection were positively correlated with BMI ( P < 0.05 )andΔC peptide( P<0.05,P <0.01). ΔC peptide was negatively correlated with the duration of disease( P< 0.05). There was no difference between patients with HbA 1c≥7.0% and HbA 1c<7.0% in basal C peptide level. But the stimulated C peptide level and theΔC peptide level significantly higher in the latter than in the former ( P <0.05). Conclusion The glucagon test is a simple, reliable and useful tool for chemical evaluation of the residual beta cell function.