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目的探讨血清C肽(CP)水平检测在2型糖尿病患者病程发展的中临床价值。方法选择驻马店市中心医院收治的196例2型糖尿病患者根据病程情况分为A(52例,病程在1年内)、B(48例,病程1~5年)、C(47例,病程在6~10年)、D(49例,病程在10年以上)4组,全部患者予以75 g无水葡萄糖采用200 ml进行冲服,并对开始口服葡萄糖第1口开始计时,分别于服糖前(T0)、服糖后1 h(T1)、2h(T2)及3 h(T3)进行采血,并对血清C肽水平进行检测。对4组患者不同服糖时间段的C肽水平及C肽曲线下面积(C-PAUC)进行分析,并对4组患者的FBG、FINS、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMAIS)进行观察比较。结果 B、C、D组患者T0、T1、T2、T3时间段的CP值及C-PAUC值显著低于A组(P<0.05)。B、C组患者T0、T1、T2、T3时间段的CP值及C-PAUC值显著高于D组(P<0.05)。B、C、D组患者的FBG、FINS、HOMA-β水平显著高于A组(P<0.05)。B、C组患者的FBG、FINS、HOMA-β水平显著低于D组(P<0.05)。结论 2型糖尿病患者随着病程的发展,血清CP水平越低,且存在胰岛β分泌功能持续受损及胰岛素抵抗,需要及时予以促进胰岛素分泌及改善胰岛素抵抗的治疗措施。
Objective To investigate the clinical value of detecting serum C-peptide (CP) level in the course of disease in type 2 diabetic patients. Methods One hundred and sixty-six patients with type 2 diabetes admitted to Central Hospital of Zhumadian were divided into A (52 cases, course of disease within one year), B (48 cases, course of disease from 1-5 years), C (47 cases, course of disease within 6 ~ 10 years), D (49 cases, duration of more than 10 years) 4 groups, all patients were given 75 g of anhydrous glucose with 200 ml to be punctured, and the beginning of the first oral glucose started counting, T0, 1 h (T1), 2 h (T2) and 3 h (T3) respectively. The levels of serum C-peptide were detected. The levels of C-peptide and C-PAUC in different time points of the four groups were analyzed. The FBG, FINS, insulin secretion index (HOMA-β), insulin resistance index HOMA-IR), insulin sensitivity index (HOMAIS) were observed and compared. Results The values of CP and C-PAUC in group B, C and D at T0, T1, T2 and T3 were significantly lower than those in group A (P <0.05). The CP values and C-PAUC values in group B and C at T0, T1, T2 and T3 were significantly higher than those in group D (P <0.05). The levels of FBG, FINS and HOMA-β in group B, C and D were significantly higher than those in group A (P <0.05). The levels of FBG, FINS and HOMA-β in group B and C were significantly lower than those in group D (P <0.05). Conclusions With the development of course of disease, the lower serum CP level in patients with type 2 diabetes mellitus and the persistent impaired pancreatic beta-secretory function and insulin resistance, it is necessary to promptly promote insulin secretion and improve insulin resistance.