2型糖尿病患者血清C肽水平与胰岛素应用的相关性研究  

Clinical Value of Serum C-peptide Levels for Insulin Therapy of Patients with Type 2 Diabetes Mellitus

作　　者：肖月星[1] 冯春鹏[1] 邓岚[1] 

机构地区：[1]中国中医科学院广安门医院内分泌科,北京100053

出　　处：《解放军预防医学杂志》2017年第6期607-610,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：北京市科委重大项目课题(No.H020920010330);中国中医科学院中医治疗有特色和优势病种项目(No.CACMS05Y0026)

摘　　要：目的研究2型糖尿病患者血清C肽水平与胰岛素应用的相关性,旨在为临床上治疗2型糖尿病提供相关理论依据。方法选取我院糖尿病内科在2014年2月-2015年12月收治的100例2型糖尿病患者。根据治疗方案将患者分成两组(每组50例),对照组予口服降糖药物治疗,观察组予胰岛素加用口服药物治疗,所有患者均进行标准的馒头餐试验。治疗前,比较两组患者各指标值的差异;治疗半个月后,观察2组患者空腹血糖(FBG)及餐后2h血糖(2hBG)水平变化及随访期间血糖控制情况。结果观察组在各时间点C肽表达水平及C-PAUC均低于对照组(P<0.05);而HbA1c、GAUC及各时间点的BG均高于对照组(P<0.05);C肽曲线下面积与年龄、FCP、各时间点C肽及各时间点CP/BG比值呈正相关(P<0.05),与病程、HbA1c、GAUC及各时间点血糖水平呈负相关(P<0.05),与体质量指数无关(P>0.05);治疗后,两组患者与之前比较血糖均有好转(P<0.05),两组患者治疗后比较差异无统计学意义(P>0.05);随访半年期间所有患者均未出现血糖异常情况。结论 2型糖尿病患者血清C肽表达水平与年龄、病程、血糖相关,胰岛素治疗2型糖尿病会使C肽水平上升,提示有可能停用胰岛素而改服降糖类药物。Objective To investigate the clinical value of serum c-peptide levels for insulin therapy of diabetics in order to provide relevant data for the treatment of type 2 diabetes mellitus. Methods One hundred cases of type 2 diabetes mellitus trea- ted in our hospital between February 2014 and December 2015 were selected. These patients were equally divided into two groups according to treatment methods. The control group was given OAD ,while the observation group was given insulin and OAD. All the patients were subjected to the steamed bread test. Before treatment, the indexes of the two groups were compared. After half a month, changes of FBG and 2hBG and the effect of blood glucose control in the two groups were observed during follow-up. Re- sults There was no statistically significant difference in gender, age, and the course of disease between the two groups （P〉0. 05 ）. C-peptide levels and C-PAUC in the observation group were lower than in the control group （ P〈0.05 ） at each time point, while levels of HbA1 c, GAUC and BG were higher than in the control group （P〈0. 05 ）. AUC of c-peptide was positively correlated with age,FCP,c-peptide levels and CP/BG ratio at each time point（ P〈0. 05 ）, but was negatively correlatedwith the course of disease, HbAI c, GAUC, blood sugar levels at each time point（ P〈0. 05 ）, and was not correlated with BMI （P〉0.05）. After treat- ment, blood glucose obviously improved （ P〈0. 05 ）, but the difference between the two groups after treatment was of no statistical significance （P〉0. 05 ）. All the patients were followed up for half a year, and no abnormal glucose levels were found. Conclu- sion C-peptide levels in patients with type 2 diabetes are associated with age, duration of disease, and blood glucose, and insulin therapy also increases the level of C-peptide in type 2 diabetes, suggesting the possibility of discontinuing insulin and switching to antidiabetic drugs.

关 键 词：C肽 2型糖尿病 胰岛素 临床价值 

分 类 号：R587.1[医药卫生—内分泌]