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目的探讨胰岛素释放曲线评定法评价多囊卵巢综合征(PCOS)胰岛素抵抗(IR)的效果。方法选取2012年8月~2013年9月在该院就诊的170例PCOS患者,分析其OGTT-胰岛素释放试验(IRT)结果。应用胰岛素释放曲线评定法将研究对象分为IR-A组和非IR-B组、应用QUCIKI指数法分为IR-C组和非IR-D组,比较各组患者空腹及口服75 g葡萄糖后1 h、2 h、3 h的胰岛素值,并以QUCIKI指数法为标准计算胰岛素释放曲线评定法的灵敏度及特异度。结果 IR-A组胰岛素水平显著高于非IR-B组、IR-C组胰岛素水平显著高于非IR-D组,各时间点胰岛素水平分布情况比较,差异有统计学意义(P<0.05)。IR-A组与IR-C组各时间点胰岛素水平分布情况比较,差异无统计学意义(P>0.05),非IR-B组与非IR-D组空腹、1h、2 h胰岛素水平分布情况比较,差异无统计学意义(P>0.05)。以QUCIKI指数法为标准,胰岛素释放曲线评定法诊断IR的灵敏度为83.85%,特异度为67.50%。结论胰岛素释放曲线评定法与QUCIKI指数法评价效果一致,前者应用简便、直观,可直接评估胰岛β细胞功能状态,值得临床推广应用。
Objective To investigate the effect of insulin release curve assessment on insulin resistance (PCOS) in patients with polycystic ovary syndrome. Methods A total of 170 patients with PCOS admitted to our hospital from August 2012 to September 2013 were selected to analyze the results of OGTT-insulin release test (IRT). The subjects were divided into IR-A group and non-IR-B group according to the method of insulin release curve. The patients were divided into IR-C group and non-IR-D group by QUCIKI index method. 1 h, 2 h, 3 h insulin value, and QUCIKI index method as the standard calculation of insulin release curve assessment sensitivity and specificity. Results The level of insulin in IR-A group was significantly higher than that in non-IR-B group. The insulin level in IR-C group was significantly higher than that in non-IR-D group. There was significant difference in insulin level at each time point (P <0.05) . There was no significant difference in the distribution of insulin between IR-A group and IR-C group at each time point (P> 0.05). The fasting, 1h, 2h insulin levels in non-IR-B group and non-IR- The difference was not statistically significant (P> 0.05). According to the QUCIKI index method, the sensitivity of insulin release curve assessment was 83.85% and the specificity was 67.50%. Conclusion The assessment of insulin release curve is consistent with the QUCIKI index method. The former is simple and intuitive, and can directly evaluate the functional status of pancreatic β cells, which is worthy of clinical application.