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1目的 探讨 2型糖尿病并发慢性血管病变病人胰岛素和胰高糖素水平的变化及意义。 2方法 采用放射免疫法分别检测了 85例病人空腹及左旋精氨酸 (L - ARG)刺激后 2 ,4,6 m in时的胰岛素 (INS)、胰高糖素水平的变化 ,并与 6 0例健康人进行对照。 3结果 2型糖尿病并发血管病变组空腹胰岛素及胰高糖素水平明显高于对照组和无血管病变组 (F=8.6 5 ,10 .6 5 ,q=3.72～ 6 .48,P<0 .0 5 ,0 .0 1) ;L - ARG刺激后对照组和 2型糖尿病组INS和胰高糖素分泌均在 2 min时达峰值 ,2型糖尿病并发血管病变组 2 min时的 INS分泌值及 2 ,4min时的胰高糖素分泌值均明显高于无血管病变组 (F =4.93～ 73.6 7,q=3.0 2～ 4.97,P<0 .0 5 ,0 .0 1) ;2型糖尿病并发血管病变组空腹 INS及峰值 INS水平分别与空腹及峰值胰高糖素水平呈正相关 (r=0 .5 33,0 .6 19,P均 <0 .0 0 1)。 4结论有血管病变的 2型糖尿病病人存在明显的胰岛素抵抗 (IR)和高胰高糖素血症 ;IR及高胰高糖素血症与糖尿病性血管病变的发生、发展有密切关系。
1 Objective To investigate the changes and significance of insulin and glucagon in type 2 diabetic patients with chronic vascular disease. 2 Methods Radioimmunoassay was used to detect the changes of insulin (INS) and glucagon in 85 patients at 2, 4 and 6 mins after fasting and L - arginine (L - ARG) 0 healthy controls. 3 Results Type 2 diabetic patients with vascular lesions fasting insulin and glucagon levels was significantly higher than the control group and no vascular disease group (F = 8.65, 10.65, q = 3.72 ~ 6.48, P <0. 0 5, 0. 01). INS and glucagon secretion in control group and type 2 diabetes group peaked at 2 minutes after L - ARG stimulation. INS secretion in type 2 diabetes mellitus group at 2 minutes And 2, 4min glucagon secretion were significantly higher than those without vascular disease group (F = 4.93 ~ 73.67, q = 3.02 ~ 4.97, P <0.05, 0.01); type 2 Fasting INS and peak INS levels were positively correlated with fasting and peak glucagon levels in patients with diabetic concurrent vascular disease (r = 0.533, 0.619, P <0.01). 4 Conclusion There is obvious insulin resistance (IR) and hyperglycemia in patients with type 2 diabetes mellitus with vascular disease. IR and hyperglycemia are closely related to the occurrence and development of diabetic vascular disease.