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目的:探讨瑞格列奈联合口服葡萄糖耐量-胰岛素释放试验在评价初诊2型糖尿病患者β细胞功能方面的价值。方法:35例初诊2型糖尿病患者,诊断时行口服葡萄糖耐量试验,分别于次日及规律治疗7 d后隔夜空腹状态下提前15 min口服2 mg瑞格列奈,再次行口服葡萄糖耐量试验,并分别定义为A,B,C组。各组均抽取空腹、30 min和120 min静脉血,测定血糖、真胰岛素及放射免疫性胰岛素,并计算真胰岛素/放射免疫性胰岛素值及早时相胰岛素分泌指数。结果:30 min时,3组真胰岛素差异有统计学意义(P<0.05);真胰岛素/放射免疫性胰岛素值C组>B组>A组(P<0.05);C,B组早时相胰岛素分泌指数均较A组显著增加(P<0.01)。结论:瑞格列奈能够显著增加早时相真胰岛素释放量及真胰岛素/放射免疫性胰岛素值;瑞格列奈联合口服葡萄糖耐量-胰岛素释放试验较常规口服葡萄糖耐量-胰岛素释放试验能够更加真实地反映初诊2型糖尿病患者胰岛β细胞分泌和储备功能。
Objective: To investigate the value of repaglinide combined with oral glucose tolerance-insulin release test in assessing β-cell function in newly diagnosed type 2 diabetic patients. Methods: 35 patients with newly diagnosed type 2 diabetes mellitus received oral glucose tolerance test at the time of diagnosis. Oral administration of 2 mg repaglinide was given 15 min earlier on the next day and regular fasting 7 days after the regular treatment. Oral glucose tolerance test was conducted again. And defined as A, B, C groups respectively. Fasting, 30 min and 120 min venous blood samples were taken from each group. Blood glucose, true insulin and radioimmunity insulin were measured. True insulin / radioimmunity insulin and early phase insulin secretion index were calculated. Results: True insulin was significantly different in the three groups at 30 min (P <0.05), while true insulin / radioimmune insulin (C) was higher in group B than in group A (P <0.05) Insulin secretion index than the A group increased significantly (P <0.01). Conclusion: Repaglinide can significantly increase the amount of early phase true insulin release and true insulin / radioimmunological insulin values; repaglinide combined with oral glucose tolerance - insulin release test can be more true than the conventional oral glucose tolerance - insulin release test To reflect newly diagnosed type 2 diabetes pancreatic β-cell secretion and reserve function.