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目的 :探讨静脉-口服双重高葡萄糖钳夹试验的临床影响因素、技术难点和处理对策。方法 :对12名健康男性志愿者进行随机开放、四阶段交叉静脉-口服双重高葡萄糖钳夹试验,评价试验过程中的技术难点、影响因素,并寻找对策。结果:钳夹试验的2个高糖阶段胰岛素均呈现经典的两相分泌模式。在钳夹过程中的临床难点包括静脉通路的维持、受试者依从性的提高、血糖稳态的建立、低血糖事件的发生及采样的精确性等,根据不同情况给予积极处理。结论:双重高葡萄糖钳夹试验能够精确评估胰岛细胞功能和肠促胰素效应,针对受试者钳夹试验时所出现的临床问题采取相应对策是钳夹试验顺利完成的关键。
Objective: To investigate the clinical influencing factors, technical difficulties and countermeasures of intravenous-oral double high glucose clamp test. Methods: Twelve healthy male volunteers were randomized to open a four-stage crossover venous-oral double high-glucose clamp test to evaluate the technical difficulties and influencing factors during the test and to find out the countermeasures. Results: The two high glucose phase insulin in the clamp test showed the classic two-phase secretion pattern. Clinical difficulties in the clamping process include the maintenance of venous access, improved compliance of subjects, the establishment of blood glucose homeostasis, the occurrence of hypoglycemia events and the accuracy of sampling, etc., according to different situations to give positive treatment. CONCLUSIONS: The dual high-glucose clamp test accurately measures pancreatic islet cell function and the incretin effect. The key to the successful completion of the clamp test is to take appropriate measures against the clinical problems that occur during the clamp test.