【摘要】 目的　观察肝硬化患者对胰高糖素负荷后的血糖反应能力。方法　 38例肝硬化患者按Child Pugh肝功能分级 ,分为A级 (1 0例 )、B级 (1 4例 )及C级 (1 4例 )三个亚组。 1 1例健康者为对照组。清晨空腹采集基础血糖标本后 ,按每公斤体重 2 .5μg胰高糖素快速静脉注射 (30s内 ) ,分别于注射后 5、1 0、1 5、30及 45min采集血糖标本。 结果　肝硬化各组的基础血糖与对照组比较无显著差异。胰高糖素负荷后 5min血糖开始升高 ,1 5～ 30min达高峰 ,多数达峰时间为 30min。肝硬化各组的血糖反应曲线均低于对照组 ,且肝硬化程度愈严重 ,血糖反应曲线愈低。峰值血糖浓度在肝硬化总体为 [(5 .71± 0 .75)mmol/l] ,A级为 [(6 .2 5± 0 .48)mmol/l] ,B级为 [(5 .48± 0 .60 )mmol/l]及C级为 [(5 .1 1±0 .67)mmol/l] ,均显著低于对照 [(7.2 8± 0 .89)mmol/l] ,且随肝硬化严重程度增加而显著降低。结论　肝硬化患者对胰高糖素负荷的血糖反应能力减弱 ,并随肝硬化严重程度增加而减弱更多还原

【Abstract】 Objective To observe the capability of blood glucose response to a loading dose of glucagon in cirrhotic patients.Methods 38 cirrhotic patients were categorized into A,B and C subgroups (grade A: 10 patients, grade B:14 patients, grade C:14 patients) according to Child Pugh score. The 38 cirrhotic patients and another 11 normal controls were given rapidly intravenous injection of glucagon (2.5μg/kg body wt) via a cannula after over night fasting. Venous blood samples were obtained from the cannula before and 5, 10,15, 30 and 45 minutes after the injection. Results The baseline blood glucose concentration wasn’t significantly different in the cirrhotic patients and in the controls. The increase of blood glucose levels at the beginning in all subjects appeared at 5 min and the peak levels appeared at 15 min or 30 min, but mostly at 30 min after a loading dose of glucagon. The curves of blood glucose response to glucagon were lower in all cirrhotic groups than those in the controls, and had a significant decrease in those with deteriorated liver function. The peak values of blood glucose in total cirrhotic group (5.71±0.75mmol/l), grade A (6.25±0.48mmol/l),grade B (5.48±0.60mmol/l) and grade C (5.11± 0.67 mmol/l) were significantly lower than those in the controls (7.28±0.89mmol/l). The more severe the liver function, the lower the peak values of blood glucose.Conclusion The capability of blood glucose response to a loading dose of glucagon is weakened in cirrhotics, the more deteriorated the liver function, the weaker the response.更多还原