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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 early phase of pancreatic β cells in non-insulin dependent diabetes mellitus (NIDDM) patients with coronary heart disease. Methods: The arginine excitatory test and radioimmunoassay were used to detect the levels of insulin, C-peptide (C-P) and insulin resistance in 85 patients at 2,4,6min after fasting and L-arginine ) Level changes, and compared with 50 cases of healthy people at the same period. Results: The fasting INS and C-P in NIDDM patients with coronary heart disease were significantly higher than those in control group and non-vascular disease group (t = 2.131 ~ 4.971, P <0.001,0.05) INS and C-P secretion in NIDDM group without vascular disease and coronary artery disease were both peaked at 2min after stimulation, and INS and C-P secretion values at 2min, 4min and 6min after NIDDM with coronary heart disease were significantly higher In the non-vascular group (t = 2.147-9.773, P <0.001,0.01,0.05), the fasting INS, C-P and L-ARG in the NIDDM with obesity group After INS and C-P peak were significantly higher than non-obese group (t = 2.485 ~ 4.996, P <0.001,0.01,0.05). CONCLUSIONS: NIDDM patients with coronary heart disease have more severe insulin resistance (IR), accompanied by more obesity, increased early phase secretion of pancreatic β-cells after stimulation with L-arginine, and increased IR and insulin secretion in patients with NIDDM Coronary heart disease, hair?