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1、.型糖尿病患者血清胰岛素浓度与血糖、糖化血红蛋白、C肽及血压、血脂的相关性研究关心1，赵玉红1，平静2，王晓蕾1，李坚1，卢熠1，吴丽霞1. 1沈阳医学院沈洲医院, 沈阳110002；2沈阳药科大学药学院, 沈阳110016RELEVANCE STUDIESOF SERUMINSULINCONCENTRATION, BLOODGLUCOSEANDGLYCOSYLATEDHEMOGLOBINTHEINTYPE2 DIABETESPATINTSGuan xin1, Zhao yuhong1, Ping jing2, Wang xiaolei 1, li jian1, Lu yi1 , Wu lix
2、ia1 1 Shenzhou Hospital affiliatedShenyang Medical College, Shenyang110002; 2 Shenyang Pharmaceutical University, Shenyang110016AbstractObjective: To study fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc), and insulin(Ins)concentrations 3 indicators of mutual relations in patients with t
3、ype 2 diabetes and the clinical application. Method: FBG, HbAle, Ins concentrations were Respectively determined by enzymatic oxidation, immunization turbidity, chemiluminescence.After treatment of the diabetic patients 1 month and 2 months , we reexamined. Results: type 2 diabetes in the FBG, HbAlc
4、, Ins were significantly higher than the normal control group (P 0.01). Conclusion: Glucose metabolism target and Ins level relations: in impaired glucose tolerance (IGT) to the clinical early time, has been in existence Insresistance, the relative lack of Ins can compensatory increase in the FBG to
5、 maintain the normal limit level; Clinical early to mid-FBG increased,Ins resistance gradual increase, the Ins level relative insufficiency hastens obviously,-cell function appears from strengthens to the weaken transformation,in blood Ins levels were unstable state of fluctuation, is in the earlier
6、 decompensated period; The clinical mid and late stage, appears continues high FBG, the serious Ins resistance still existed, starts to present the Ins to be absolutely insufficient, Beta cell function is in a decompensated period or the failure time, the blood insulin level reduces unceasingly. The
7、 entire diabetes course, the typical Ins concentration curve was inverted U-shaped approximately. As FBG, HBAIc, and Ins reflects the three different periods of FBG level, to provide a recent clinical vertical, the entire process of FBG level of information to guide clinical development of treatment
8、 programmes. Key words:Diabetes; Glycosylated hemoglobin; Insulin; Hypertensin摘要目的 探讨型糖尿病患者血糖(FBG)、糖化血红蛋白(HbAlc)、胰岛素(Insulin)、C肽（CPE）测定指标之间相互关系的临床应用，同时研究了与血压、血脂的相关性。方法 选择型糖尿病人94例, 正常对照组36例。采用葡萄糖氧化酶方法、免疫透射比浊法和微粒子化学发光法分别测定FBG、HBAlc、Insulin和C肽浓度。血清胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-Ch)和低密度脂蛋白胆固醇(LDL-Ch)的测定
9、是用常规的生化方法测定。结果 型糖尿病中的FBG、HbAlc、Insulin和CPE明显高于正常对照组(P0.05)。1.4 计学方法：计量资料以均数 标准差(MSD)表示 ，两组间比较采用 t检验结果，多组间比较用方差分析。上述所有测定都由本室测定并有质控血参照，其批内CV小于1O；批间CV小干20。2 结 果 2.1 葡萄糖耐量曲线下面积的比较: 图2显示各观察组葡萄糖耐量曲线下面积的比较，发现高血脂合并型糖尿病组与高血压合并型糖尿病组的葡萄糖耐量曲线下面积均比体重正常者的面积增加。并观察到高血脂合并高血压合并型糖尿病组的葡萄糖耐量曲线下面积比非肥胖者的面积明显增加 0.05)，达峰时间较
10、正常者延迟,说明2型糖尿病高血压合并高血脂的人存在糖代谢的异常加重倾向。表1. 5组病例空腹胰岛素、血糖、C肽和糖化血红蛋白表组别例数空腹胰岛素浓度空腹血糖空腹C肽糖化血红蛋白INSFBGCPEHbAlcA3638.1417.445.440.88379.9176.904.980.49B1839.9432.6210.93.75531.57198.867.141.90C2656.5538.3811.03.88612.26137.127.791.89D2950.5125.69.173.59478.93209.657.921.93E3157.2626.1611.03.74967.4163.727.811.86表2. 5组病例血脂表组别例数甘油三脂载脂蛋白A1载脂蛋白A:B脂蛋白(a)载脂蛋白B高密度脂蛋白胆固醇低密度脂蛋白胆固醇总胆固醇TGApoA1ApoA:BLP(a)ApoBHDL-CLDL-CCHOA361.360.511.310.141.590.31159.80.90.11.750.223.680.445.80.7B
