严重创伤后,病人体内的胰岛素水平有一个依赖于时间的变化。在急性期,葡萄糖耐量减低,胰岛素过度分泌但尚不足以对应血浆葡萄糖水平的增高;到损伤后期,胰岛素的分泌使葡萄糖代谢转趋正常。测定人体胰岛素水平的最大障碍在于不能直接测得其在门静脉循环中的水平,以了解胰岛素的确切产率。因为周围血中胰岛素水平同时反映了胰岛素分泌和胰岛素代谢廓清率。研究发现,在胰腺β细胞中前胰岛素原通过酶裂变产生胰岛素和C肽,然后以等分子量分泌到门静脉血中。肝脏摄取约 After a serious trauma, there is a time-dependent change in the level of insulin in the patient’s body. In the acute phase, impaired glucose tolerance, insulin over-secretion but not enough to correspond to increased plasma glucose levels; to the late injury, the secretion of insulin glucose metabolism normal. The biggest obstacle in determining human insulin levels is the inability to directly measure its level in the portal circulation to understand the exact insulin yield. Because peripheral blood insulin levels reflect both insulin secretion and insulin clearance. The study found that pro-proinsulin in pancreatic beta cells produced both insulin and C-peptide by enzymatic cleavage and then secreted into the portal vein at an equal molecular weight. Liver uptake about