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目的 探讨肾综合征出血热 ( HFRS)患者胰岛β细胞的储备功能 ,为临床治疗该病的用药提供依据。方法 对 63例患者进行了静脉法糖耐量试验 ,并同时检测了血清各时相 C肽和胰岛素水平。结果 糖负荷后血清 C肽峰值仅为基值的 2 .9倍 ,30、60 min血清 C肽水平均显著低于对照组 ( P <0 .0 1 )。血清胰岛素与 C肽水平相平行 ,糖负荷后 34.9%的患者出现胰岛素低平曲线。此外 ,随病情加重 ,胰岛 β细胞储备功能减退更为显著 ,糖代谢紊乱程度亦愈加明显。结论 HFRS患者存在胰岛 β细胞储备功能不足。及时检测血糖 ,酌情加用适量胰岛素对病人可能有利。
Objective To investigate the reserve function of pancreatic β-cell in patients with hemorrhagic fever with renal syndrome (HFRS) and provide basis for the clinical treatment of the disease. Methods Sixty-three patients underwent intravenous glucose tolerance test, and the levels of C-peptide and insulin in each phase of serum were detected simultaneously. Results The peak value of serum C-peptide was only 2.9 times of the basal value, and the level of serum C-peptide at 30 and 60 minutes was significantly lower than that of the control group (P <0.01). Serum insulin paralleled C-peptide levels, and 34.9% of patients showed low-grade insulin curves after the glucose load. In addition, with the aggravating illness, pancreatic β-cell reserve function is more significant, the degree of glucose metabolism disorder is also more pronounced. Conclusion HFRS patients have islet β-cell reserve insufficiency. Timely detection of blood glucose, as appropriate, plus appropriate amount of insulin may be beneficial to the patient.