C_2/C_0在初诊2型糖尿病患者β细胞功能评价中的作用  

Effect of C_2/C_0 Ratio on Assessing β Cell Function in Newly Diagnosed Type 2 Diabetic Patients

作　　者：唐祝奇[1] 崔世维[1] 朱晓晖[1] 王粹芳[1] 印彤[1] 

机构地区：[1]江苏省南通大学附属医院内分泌科,226001

出　　处：《中华全科医学》2010年第10期1230-1231,共2页Chinese Journal of General Practice

摘　　要：目的探讨初诊2型糖尿病患者标准馒头餐后2小时C肽与空腹C肽比值(C2/C0)的临床意义。方法初诊T2DM患者87例,分为Ⅰ组(C2/C0≥3,n=43)和Ⅱ组(C2/C0<3,n=44)。经2～3周的胰岛素泵强化治疗,3个月后随访,比较两组间的降糖方案和血糖控制情况。结果胰岛素泵强化治疗后空腹及餐后血糖控制良好。随访时胰岛素抵抗指数无显著差异(2.48±0.89vs.2.31±1.54,P>0.05);胰岛素分泌指数显著上升(147.2±58.4vs.25.8±23.6,P<0.01)。Ⅰ组比Ⅱ组有更多的患者可采用单独生活方式干预控制血糖良好(20/43vs.5/44,P<0.05);Ⅱ组比Ⅰ组有更多的患者需胰岛素(≥20U/d)控制血糖(21/44vs.9/43,P<0.05);需用口服降糖药者两组间在病例数上无显著差别(14/43vs.18/44,P>0.05),但Ⅰ组患者比Ⅱ组患者需要的降糖药物更少。结论初诊2型糖尿病患者的C2/C0比值,可用于评价患者β细胞功能,指导治疗方案的选择。Objective To investigate the clinical significance of the ratio of 2 h postprandial C-peptide to fasting（C2/C0） in newly diagnosed type 2 diabetic patients.Methods Eighty-seven of newly diagnosed type 2 diabetic inpatients were enrolled in this clinical trial,and were divided into two groups by the ratio of C2/C0：groupⅠ（C2/C0≥3）and group Ⅱ（C2/C03）,then treated with continuous subcutaneous insulin infusion for 2 to 3 weeks.After 3 months follow up,the levels of blood glucose control were compared between two groups.Results After intensive therapy,fasting and 2H postprandial blood glucose were controlled well.There was no significant difference in Homa IR before and after therapy（P0.05）,and Homa B% increased significantly after therapy（P0.01）.Compared to group Ⅱ,more patients in groupⅠ can get good glucose control by life style intervention alone（20/43 vs 5/44）,and less patients in group I（21/44 vs 9/43,P0.05） need insulin therapy（≥20 U/d）.The difference in the numbers of patients who need oral antidiabetic drug had no statistical significance（14/43 vs 18/44,P0.05）,but the dose needed in the group I was lower than that in group Ⅱ.Conclusion The ratio of C2/C0 can be used to assess β cell function in newly diagnosed type 2 diabetic patients.The patients with C2/C0≥3 can get more benefits from short-term intensive insulin therapy than those with C2/C03.

关 键 词：2型糖尿病 C-肽 血糖 胰岛素强化治疗 

分 类 号：R587.1[医药卫生—内分泌] R446.11[医药卫生—内科学]