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目的:探讨2型糖尿病患者经标准馒头餐试验后胰高血糖素、胰岛素水平变化及其临床意义。方法:选取我院2014年3月至2015年3月收治的80例2型糖尿病患者为试验组,均接受标准馒头餐试验,对其餐前及餐后0.5 h、1 h、2 h胰高血糖素及胰岛素水平进行检测,并与同期80例血糖无异常的健康对照组作比较。结果:健康对照组餐前及餐后胰高血糖素水平无明显变化(P>0.05),而试验组餐前胰高血糖素水平明显高于健康对照组(P<0.05),且餐后明显升高,在餐后1 h达到峰值,餐后0.5 h、1h、2 h均明显高于健康对照组(P<0.01)。健康对照组餐后胰岛素水平明显升高,在餐后1 h达到峰值后开始降低,较餐前略高,但差异平无统计学意义(P>0.05);试验组餐前胰岛素水平明显低于健康对照组(P<0.05),且餐后水平升高幅度缓慢,餐后0.5 h、1 h、2h均明显低于健康对照组(P<0.05);实验组胰岛素抵抗指数(HOMA-IR)明显高于健康对照组,经Pearson相关分析,试验组餐后0.5 h、1 h、2 h胰高血糖素水平与HOMA-IR均呈明显的正相关(r=0.273、0.335、0.368,P<0.05)。结论:2型糖尿病患者血糖高表达与胰高血糖素、胰岛素水平密切相关,胰高血糖素可拮抗胰岛素,及时检测二者的水平对临床准确评估病情具有重要的意义。
Objective: To investigate the changes of glucagon and insulin after standard steamed bread test in type 2 diabetic patients and its clinical significance. Methods: Eighty patients with type 2 diabetes mellitus admitted to our hospital from March 2014 to March 2015 were selected as the experimental group. All patients underwent standard steamed bread meal test, and their pre-prandial and postprandial 0.5 h, 1 h, 2 h Glucagon and insulin levels were detected and compared with 80 healthy people without abnormal blood glucose during the same period. Results: There was no significant difference in pre-and post-prandial glucagon levels in healthy control group (P> 0.05), while the pre-prandial glucagon level in test group was significantly higher than that in healthy control group (P <0.05) (P <0.01), which reached the peak at 1 hour after meal and significantly higher than that of healthy control group at 0.5 h, 1 h and 2 h after meal (P <0.01). The level of postprandial insulin in the healthy control group increased significantly and reached a peak at 1 h after meal, which was lower than that before meal, but the difference was not statistically significant (P> 0.05). The pre-meal insulin level in the test group was significantly lower than that in the healthy group (P <0.05), and the level of postprandial increase was slow. The postprandial 0.5 h, 1 h and 2 h were significantly lower than that of the healthy control group (P <0.05). The insulin resistance index (HOMA-IR) Compared with healthy control group, Pearson correlation analysis showed that there was a significant positive correlation between HgA-IR and HOMA-IR at 0.5 h, 1 h and 2 h after meal in experimental group (r = 0.273,0.335,0.368, P <0.05 ). Conclusion: The high expression of blood glucose in type 2 diabetic patients is closely related to the level of glucagon and insulin. Glucagon can antagonize insulin and timely detection of both levels is of great significance for accurate clinical assessment of the disease.