两步法高胰岛素正常葡萄糖钳夹技术的建立  

Establishment of a two-step hyperinsulinemic euglycemic clamp technique

作　　者：罗四川[1] 李启富[1] 黄健康[1] 汪志红[1] 刘秀容[1] 张素华[1] 舒昌达[1] 

机构地区：[1]重庆医科大学附属第一医院内分泌科,400016

出　　处：《中华糖尿病杂志（1006-6187）》2005年第1期39-42,共4页

基　　金：重庆市卫生局科研基金资助项目(2003-2-112)

摘　　要：目的　建立两步法高胰岛素 正常葡萄糖钳夹技术。　方法　应用两步法高胰岛素-正常葡萄糖钳夹术(第一阶段胰岛素输注速率为 30 mU·m-2 ·min-1,第二阶段为 120 mU·m-2 ·min-1),评估10名健康女性志愿者的胰岛素敏感性,同时监测钳夹试验过程中循环血内源性升糖激素(胰高血糖素、皮质醇、生长激素)和游离脂肪酸(FFA)浓度变化。　结果　(1)两步法高胰岛素 正常葡萄糖钳夹术第一阶段(60~90 min)和第二阶段(150~180 min) 稳态血胰岛素分别维持在(46±7)mU/L和(218±27)mU/L,稳态葡萄糖利用率分别为(7.2±1.4)mg·kg-1·min-1和(13.1±1.2)mg·kg-1·min-1;(2)钳夹试验过程中,血清胰高血糖素、皮质醇和 FFA水平较基础值均有显著下降,而生长激素和C肽水平无明显改变。　结论　成功建立了两步法高胰岛素 正常葡萄糖钳夹术;钳夹试验过程中高浓度的胰岛素抑制了胰高血糖素、皮质醇的分泌,并减少脂肪分解。Objective To establish a two-step hyperinsulinemic euglycemic clamp technique. Methods A two-step hyperinsulinemic euglycemic clamp (30 mU·m^(-2)·min^(-1) and 120 mU·m^(-2)·min^(-1)) was established and applied to 10 nonobese healthy Chinese women with normal glucose (tolerance.) Results (1) During the clamp, the steady-state plasma insulin levels at the first step (60~90min) and the second step (150~180min) were(45.6±7.3)mIU/L and (217.8±27.2)mIU/L (respectively.) The steady-state glucose metabolism rates of the first step and the second step were (7.24±1.38) mg·kg^(-1)·min^(-1) and (13.08±1.16) mg·kg^(-1)·min^(-1) respectively. (2) During the two-step euglycemic clamp, there were significant decreases of serum cortisol, glucagon and free fatty acids compared with basal values while no significant changes occurred in serum growth hormone and C-peptide. Conclusion A two-step hyperinsulinemic euglycemic clamp was successfully established. During the clamp, the plasma insulin of high concentration inhibits lipid oxidation and the secretion of glucagon and cortisol.

关 键 词：高胰岛素 正常 葡萄糖 钳夹术 皮质醇 胰高血糖素 FFA 钳夹技术 生长激素 两步法 

分 类 号：R587[医药卫生—内分泌]