肝硬化患者胰高糖素负荷的血c-AMP及血糖反应性观察  

RESPONSIBILITY OF PLASMA c-AMP AND BLOOD GLUCOSE TO A LOADING ADMINISTRATION OF GLUCAGON IN CIRRHOTIC PATIENTS

作　　者：吴邦富[1] 林丽莉[1] 胡品津[1] 

机构地区：[1]中山医科大学附属第一医院消化科

出　　处：《中国现代医学杂志》2001年第9期3-5,共3页China Journal of Modern Medicine

摘　　要：目的 :观察肝硬化患者对胰高糖素负荷后的血c -AMP及血糖反应能力。方法 :38例肝硬化患者按Child -Pugh肝功能分级 ,分为A级 (10例 ) ,B级 (14例 ) ,C级 (14例 )三个亚组。 11例健康者为对照组。清晨空腹静卧 ,套管针肘静脉穿刺并固定 15min后采集基础血c -AMP和血糖标本 ,即刻以每公斤体重 2 .5 μg胰高糖素快速静脉注射 (30s内 ) ,分别于注射后 5 ,15 ,30及 45min采集血c -AMP和血糖标本。以放射免疫法测定血浆c -AMP浓度。以葡萄糖氧化酶法测定血糖浓度。结果 :肝硬化各组与对照组比较 ,基础血浆c-AMP浓度均显著高于对照组 ,而基础血糖无显著差异。胰高糖素负荷后 5min血浆c -AMP浓度即明显增高 ,于 10～ 15min达高峰 ,多数达峰时间在 10min ;血糖于 5min开始升高 ,15～ 30min达高峰 ,多数达峰时间在30min ,肝硬化各组的血c-AMP及血糖反应曲线均低于对照组 ,且肝硬化严重程度愈重 ,血c -AMP及血糖反应曲线愈低 ,峰值血浆c -AMP及峰值血糖浓度 ,肝硬化总体 (12 2 .0 8± 84.39pmol/ml,5 .71± 0 .75mmol/LA级 (148.0 7± 85 .0 8pmol/ml,6 .2 5± 0 .48mmol/L)、B级 (12 0 .47± 173 .34pmol/ml,5 .84± 0 .6 0mmol/L)及C级 (83 .0 4± 5 0 .96 pmol/ml,5 .11± 0 .6 7mmol/L)均显著低于对照组 (2 19.Objective:To observe the capability of plasma c-AMP and blood glucose response to a loading administration of glucagon in cirrhotic patients.Methods:38 cirrhotic patients were classified into A,B and C three subgroups (grade A:10 patients,grade B:14 patients, grade C:14 patients) according to Child-Pugh score.The 38 cirrhotic patients and another 11 normal controls were given rapidly intravenous injection of glucagon (2.5ug/kg body wt)via a cannula after over night fasting.Venous blood c-AMP and blood glucose samples were obtained from the cannula before the injection and after the injection 5,10,15,30 and 45 minutes.the RIA was used to analyze plasma c-AMP concentrations.Results:The baseline plasma c-AMP concentration was significantly higher in the cirrhotic patients than that in the controls,but the baseline blood glucose concentration wasn't significantly difference in the cirrhotic patients than that in the controls.After a loading administration of glucagons,the increase of plasma c-AMP levels and blood glucose levels in all subjects appeared at 5min.The peak valuses of plasma c-AMP levels and blood glucose appeared at 10 min or 15 min,but most at 10 min.The increase of blood glucose levels in all subjects appeared at 5 min and the blood glucose peak values appeared at 15 min or 30 min,but most at 30min.The curves of plasma c-AMP and blood glucose response to glucagon were lower in all cirrhotic groups than that in the controls,and decreased following a retrograde liver function.The peak values of plasma c-AMP and the blood glucose peak values in total cirrhotic group (122.08±84.39pmol/ml,5.71±0.75mmol/l),grade A (148.07±85.08pmol/ml,6.25±0.48mmol/l),grade B(120.56±89.58pmol/ml,5.84±0.60mmol/l) and grade C(83.04±50.96pmol/ml,5.11±0.67mmol/l)were significantly lower than that in the controls (219.47±173.34pmol/ml,Conclusions:The capability of plasma c-AMP and blood glucose response to a loding administration of glucagon in cirrhotic patients decreased,and the heaver of cirrhosis,the less response.

关 键 词：肝硬化 胰高糖素 C-AMP 血糖 

分 类 号：R575.202[医药卫生—消化系统]