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目的研究儿童青少年糖尿病diabetesmellitusDM患儿胰岛功能及分型。方法对56例DM患儿做胰高血糖素激发试验,其中C肽正常者1年后复查;以12例非DM患儿为对照。结果①DM组C肽基础值BCP、胰高血糖素刺激后C肽PGCP、C肽增高值ICP均低于对照组(P<0.05)。②C肽降低组43例BCP、PGCP、ICP均低于对照组(P<0.05);C肽正常组13例BCP、PGCP与对照组差别无显著性,ICP低于对照组(P<0.05)。③C肽正常组10例复查激发试验,6例C肽降低,4例C肽正常。④经胰高血糖素激发试验,结合临床表现,诊断初发患儿C肽降低者为1型糖尿病,C肽正常者可能为2型糖尿病,但需随访胰岛功能,1年后C肽降低者仍为1型糖尿病。结论胰高血糖素激发试验能较好反映胰岛功能,有助儿童青少年糖尿病分型。
Objective To study the islet function and classification of children with diabetes mellitusDM in children and adolescents. Methods Glucagon-stimulated test was performed on 56 children with DM, of which C-peptide was normal after 1 year and 12 children without DM were used as control. Results ① The baseline values of B peptide in C group and those of PGCP and C peptide in C group after glucagon stimulation were lower than those in control group (P <0.05). The levels of BCP, PGCP and ICP in 43 patients with C-peptide decreased were lower than those in control group (P <0.05). There was no significant difference between BCP and PGCP in normal C group and ICP in control group (P <0.05). ③ normal group of C peptide in 10 cases to review the challenge test, 6 cases of C-peptide decreased, 4 cases of C-peptide normal. ④ glucagon stimulation test, combined with clinical manifestations, diagnosis of C-peptide in children with first-onset is type 1 diabetes, normal C-peptide may be type 2 diabetes, but the need to follow-up islet function, 1 year after C-peptide decreased Still type 1 diabetes. Conclusion Glucagon-stimulated test can better reflect islet function and help children and adolescents with diabetes type.