论文部分内容阅读
目的 探讨老年 2型糖尿病患者胰岛 β细胞功能与口服降糖药继发失效 ,以及年龄、病程、体重指数等因素对其的影响。方法 85例住院的老年 2型糖尿病患者 ,静脉推注 1 mg胰高糖素 ,测定注射前和注射后 6 min的 CP,并计算Δ CP值 ,用以评价内源性胰岛β细胞分泌功能。根据病程、体重指数 (BMI)和口服降糖药有效 (OHA)和继发失效 (SF)分组 ,比较各组的 ΔCP值 ,并分析 ΔCP与年龄、病程及体重指数的相关性。结果 (1 )老年 2型糖尿病患者 BMI<2 3,BMI2 3～ <2 5,BMI≥ 2 5组间比较ΔCP无明显差异。 (2 )ΔCP随病程的延长呈进行性下降 (P<0 .0 5)。口服降糖药继发失效的发生率明显增加 ,差异有显著性。 (3)非肥胖 (BMI<2 3和 2 3～ <2 5)组 SF发生率分别为 74%、63% ,其中 SF组 ΔCP均比 OHA组低 ,差异有显著性。肥胖 (BMI≥ 2 5)组 SF发生率为 61 % ,SF组ΔCP比 OHA组低 ,差异无显著性。 (4)Δ CP与病程呈负相关 (r=- 0 .36,P=0 .0 0 3) ,而与年龄、BMI和 Hb A1 c无明显相关性。多元逐步回归分析发现病程对ΔCP的影响较大。结论 老年 2型糖尿病患者胰岛β细胞功能主要与病程有关 ,随着病程的延长 ,胰岛β细胞分泌功能呈进行性下降 ,导致口服降糖药继发失效。
Objective To investigate the effects of pancreatic β-cell function and secondary hypoglycemic agents on type 2 diabetes mellitus in elderly patients with secondary failure, age, duration of disease and body mass index. Methods Eighty-five elderly patients with type 2 diabetes mellitus were injected intravenously with 1 mg glucagon. The CP before and 6 min after injection was measured and the ΔCP value was calculated to evaluate the secretion of endogenous β cells. According to the course of disease, body mass index (BMI) and oral hypoglycemic agents (OHA) and secondary failure (SF) grouping, we compared the ΔCP value of each group and analyzed the correlation between ΔCP and age, disease duration and body mass index. Results (1) There was no significant difference in ΔCP between senile type 2 diabetic patients with BMI <2 3, BMI 2 3 ~ <25, BMI ≥ 25. (2) ΔCP decreased progressively with the course of disease (P <0.05). Oral hypoglycemic agents secondary failure significantly increased the incidence, the difference was significant. (3) The incidence of SF in non-obese (BMI <23 and 23 ~ <25) groups was 74% and 63%, respectively. The ΔCP in SF group was lower than that in OHA group, with significant difference. The incidence of SF in obese (BMI≥25) group was 61%, and the ΔCP in SF group was lower than that in OHA group, with no significant difference. (4) Δ CP was negatively correlated with the course of disease (r = - 0.36, P = 0.003), but not with age, BMI and Hb A1 c. Multiple stepwise regression analysis found that the course of the disease had a greater impact on ΔCP. Conclusion The islet β-cell function in elderly type 2 diabetic patients is mainly related to the course of the disease. With the prolongation of the disease duration, the secretion of pancreatic β-cells is progressively decreased, resulting in the secondary failure of oral hypoglycemic agents.