2型糖尿病病人胰高血糖素和胰岛素水平的变化及临床意义  

CHANGES OF PLASMA LEVELS OF GLUCAGON AND INSULIN IN PATIENTS WITH TYPE-2 DIABETES MELLITUS: A STUDY OF THEIR CLINICAL SIGNIFICANCE

作　　者：刘志才[1] 张玉江[2] 杨立廷[3] 

机构地区：[1]青岛大学医学院人体解剖学教研室,山东青岛266021 [2]青岛大学医学院继续教育科,山东青岛266021 [3]青岛大学医学院附属医院放免中心,山东青岛266021

出　　处：《青岛大学医学院学报》2003年第3期334-336,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：①目的　探讨 2型糖尿病病人空腹及馒头餐后血浆胰高血糖素、血清胰岛素含量的变化及意义。②方法　采用放射免疫法分别检测了 6 5例 2型糖尿病病人空腹及馒头餐后血浆胰高血糖素、胰岛素的水平变化 ,并与 34例健康人进行比较。③结果　糖尿病病人空腹及餐后各时相胰高血糖素水平均高于正常人 (t =16 .79～2 0 .37,P <0 .0 1)。糖尿病病人馒头餐后胰高血糖素水平明显升高 ,6 0min显著高于其空腹水平 (F =15 .4 5 ,q =5 .6 2 ,P <0 .0 1) ,180min时基本恢复到空腹水平。正常人餐后 30min胰高血糖素水平略有升高 ,后各时相逐渐下降 ,180min稍低于空腹水平 ,各时相变化均无显著性差异 (F =2 .38,P >0 .0 5 )。糖尿病病人胰岛素 /胰高血糖素比值馒头餐后上升迟缓 ,6 0min才高于其空腹水平 (F =2 .6 7,q =4 .11,P <0 .0 5 ) ;12 0、180min比值仍上升 ,亦明显高于其空腹水平 (q =4 .78、5 .4 3,P <0 .0 1)。正常对照组胰岛素 /胰高血糖素比值于馒头餐后上升快 ,6 0min达高峰(F =12 .6 7,q =5 .5 2 ,P <0 .0 1) ;180min与空腹相比无显著差异 (q =1.77,P >0 .0 5 )。④结论　 2型糖尿病病人存在较严重的胰岛A细胞功能异常 ;餐后胰岛素 /胰高血糖素比值是一项能敏感、准确判断糖尿病病情的可靠的指标。Objective\ To study the plasma levels of glucagon and insulin before and after oral glucose tolerance test ( OGTT ) in type 2 diabetes.\ Methods\ Concentration of glucagon and insulin was determined by radioimmunoassay in 65 patients and 34 healthy persons before and after OGTT. \ Results\ In diabetic patients, the glucagon was significantly increased in comparison with the control group ( t=16.79-20.37,P <0.01). Plasma levels of glucagon increased greatly in the patients after OGTT, and reached its peak at 60 minutes after OGTT ( F=15.45,q=5.62,P <0.01) and returned to original level after 180 minutes. In the control group, level of glucagon after OGTT elevated a little, then declined gradually and became lower by 180 minutes after OGTT. These changes, however, had no significance ( F=2.38,P >0.05). Compared with fasting ratio,the ratio of insulin to glucagon in the patients did not differ significantly until 60 minutes after OGTT ( F=2.67,q=4.11,P <0.05). While in healthy subjects ,the ratio increased immediately and reached its peak by 60 minutes after OGTT ( F=12.67, q=5.52, P <0.01), at 180 minutes, the difference with that of fasting level was not significant ( q=1.77,P >0.05). \ Conclusion\ Dysfunction of islet A cell exists in type 2 diabetic patients. The ratio of insulin/glucagons is a sensitive parameter to accurately judge the patients condition.

关 键 词：2型糖尿病 胰高血糖素 胰岛素 放射免疫测定 临床意义 

分 类 号：R587.1[医药卫生—内分泌]