【摘要】 ①目的　探讨２型糖尿病伴发高血压病人胰岛β细胞早期分泌相的变化规律。②方法　采用精氨酸兴奋试验及放免法，分别检测了８２ 例２ 型糖尿病病人空腹及左旋精氨酸（Ｌ－ＡＲＧ）刺激后２，４，６ｍ ｉｎ 时胰岛素（ＩＮＳ）和Ｃ肽（Ｃ－Ｐ）水平变化，并与５０ 例健康人进行对照。③结果　伴发高血压的２ 型糖尿病组空腹ＩＮＳ水平明显高于对照组和无血管病变组（Ｆ＝ ９．４１，ｑ＝ ３．９１，６．０７，Ｐ＜ ０．０１）；其Ｃ－Ｐ水平亦明显高于无血管病变组（Ｆ＝９．３３，ｑ＝ ５．８９，Ｐ＜ ０．０１）；Ｌ－ＡＲＧ刺激后无血管病变及伴发高血压的２ 型糖尿病组ＩＮＳ和Ｃ－Ｐ分泌均在２ｍ ｉｎ 时达峰值；２ 型糖尿病伴发高血压组２，４，６ｍ ｉｎ 时的ＩＮＳ，Ｃ－Ｐ分泌值均明显高于无血管病变组（Ｆ＝ １５．４２～７９．０２，ｑ＝ ３．１１～６．３１，Ｐ均＜ ０．０５，０．０１）；合并高血压的２ 型糖尿病伴有肥胖组空腹ＩＮＳ及Ｌ－ＡＲＧ兴奋后ＩＮＳ，Ｃ－Ｐ峰值均明显高于非肥胖组（ｔ＝ ２．５２～７．２４，Ｐ＜ ０．０５，０．０１）。④结论　伴发高血压的２ 型糖尿病病人存在较严重的胰岛素抵抗（ＩＲ），伴有肥胖者更明显。ＩＲ及胰岛β细胞早期分泌功能的紊乱与２ 型糖更多还原

【Abstract】 Objective\ To investigate the changes of the islet β cell early secretory phase in NIDDM patients with hypertension.\ Methods\ The serum INS and C P levels were measured with radioimmunoassay in 82 patients with type 2 diabetes mellitus and 50 health subjects at fasting and 2, 4, 6min after being injected L ARG.\ Results\ The fasting INS and C P levels were significantly higher in NIDDM patients with hypertension than those in controls or non angiopathy patients ( F=9.41,q=3.91, 6.07 ,P < 0.01 ); INS and C P in both NIDDM patients with hypertension and nonangiopathy patients reached maximal levels 2 minutes after L ARG stimulation. The INS and C P levels at 2,4,6min after L ARG injection were significantly higher in NIDDM patients with hypertension than those with non angiopathy patients ( F=15.42-79.02,q=3.11-6.31,P <0.05,0.01); The fasting and the maximal INS,C P levels after L ARG injection were significantly higher in NIDDM with hypertension accompanied by obesity than those without obesity ( t=2.52-7.24,P <0.05,0.01).\ Conclusion\ There was severe insulin resistance(IR) in NIDDM with hypertension, especially those accompanied by obesity; IR and the disorder of the islet β cell early secretory function might be related with the occurrence and development of hypertension in patients with NIDDM .\;更多还原