摘要
目的：探讨非胰岛素依赖型糖尿病（ＮＩＤＤＭ）伴发冠心病病人胰岛β细胞早期分泌相的变化规律。方法：采用精氨酸兴奋实验及放免法，分别检测了８５例病人空腹及左旋精氨酸（Ｌ—ＡＲＧ）刺激后２、４、６ｍｉｎ钟时的胰岛素（ＩＮＳ）、Ｃ肽（Ｃ—Ｐ）水平的变化，并与５０例同期健康人进行了对照。结果：伴发冠心病的ＮＩＤＤＭ组空腹ＩＮＳ及Ｃ—Ｐ明显高于对照组和无血管病变组（ｔ＝２．１３１～４．９７１，Ｐ＜０．００１，０．０５）；Ｌ—ＡＲＧ刺激后无血管病变的及伴发冠心病的ＮＩＤＤＭ组ＩＮＳ和Ｃ—Ｐ分泌均在２ｍｉｎ时达峰值，ＮＩＤＤＭ伴发冠心病组２ｍｉｎ、４ｍｉｎ、６ｍｉｎ时的ＩＮＳ、Ｃ—Ｐ分泌值均明显高于无血管病变组（ｔ＝２．１４７～９．７７３，Ｐ＜０．００１，０．０１，０．０５）；合并冠心病的ＮＩＤＤＭ伴肥胖组空腹ＩＮＳ、Ｃ—Ｐ及Ｌ—ＡＲＧ兴奋后ＩＮＳ、Ｃ—Ｐ峰值均明显高于非肥胖组（ｔ＝２．４８５～４．９９６，Ｐ＜０．００１，０．０１，０．０５）。结论：伴发冠心病的ＮＩＤＤＭ病人存在较严重的胰岛素抵抗（ＩＲ），同时伴有肥胖者更明显，左旋精氨酸刺激后胰岛β细胞早期分泌相增加；ＩＲ及胰岛细胞分泌亢进与ＮＩＤＤＭ病人冠心病的发生、发?
Objective:To investigate the changes of the islet β—cell early secretory phase in NIDDM with coronary heart disease (CHD).Method: The serum INS and C-P levels were measured in 85 patients with NIDDM at fasting and 2,4,6min after being injected L ARG with radioimmunoassay respectively,and 50 health subjects were as controls.Results:The fasting INS and C-P levels were significantly higher in NIDDM with CHD than those in controls and nonangiopathy (t=2.131～4.971,P<0.001,0.05) The INS and C-P levels at 2,4,6min after injected L—ARG were significantly higher in NIDDM with CHD than those with nonangiopathy (t=2.147～9.773,P<0.001,0.01,0.05).The fasting and the maximal INS,CP levels after injected LARG were significantly higher in NIDDM with CHD and obesity than those with nonobesity (t=2.485～4.996,P<0.01,0.001,0.05).Conclusion: there were severe insulin resistance (IR) in NIDDM with CHD,especially those with obesity,the islet βcell early secretory capacity increases in NIDDM with CHD after stimulated by L-ARG,IR and islet βcell hyperfunction mighe be related with the occurrence and development of CHD in patients with NIDDM。
出处
《河北医学》
CAS
1998年第5期12-15,共4页
Hebei Medicine
