【摘要】 选继发性磺脲类失效（１８例）和有效（１８例）两组ＮＩＤＤＭ病人，行前后两次ＯＧＴＴ和胰岛素释放试验，继发失效组中１１例再同时服优降糖重复ＯＧＴＴ。根据Ｃｅｄｅｒｈｏｌｍ等法计算胰岛素释放指数（ＩＲＧ）和胰岛素敏感性指数（ＳＩ）。结果示继发失效前与有效组比，ＩＲＧ无显著性差异，但ＳＩ减低明显（Ｐ＜０．０５）；继发失效后与有效组其ＩＲＧ和ＳＩ均减低，分别减少４５％和３４．６％、３８．３％和１１．４％。继发失效组加服优降糖重复ＯＧＴＴ，则见ＩＲＧ上升（Ｐ＜０．０５），而ＳＩ无显著性差异。说明继发性失效病人可能存在更明显的胰岛素抵抗性，即胰岛素抵抗明显或ＳＩ下降明显者更易发生继发失效。更多还原

【Abstract】 Oral glucose tolerance test(OGTT) and insulin releasing test were performed before and after treatment in two groups of NIDDM patients, each including 18 cases, with effect or secondary failure to sulfonylureas, OGTT were repeated in 11 of 18 patients with secondary failure by adding glibenclamide. Insulin reaction to glucose(IRG) and insulin sensitivity index(SI) were calculated by referring to method of Cederholm et al. At the beginning, there was no significant difference of IRG in the two groups, but lower SI in patients with secondary failure than in those with effect(P<0 05). As duration prolonged, both IRG and SI decreased in two groups (with or without effect respectively:38.3% and 11.4%, 45.0% and 34.6%). After adding glibenclamide in patients with secondary failure, IRG were significantly increased(P<0 05), but SI weren’t. The results showed that there was significant insulin resistance existing in patients with secondary failure.更多还原