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目的 研究糖尿病 (DM) 1型和 2型发病机制中胰岛素受体 (Ins R)活性改变及其治疗作用。方法 应用改良红细胞 Ins R活性放射受体分析法 ,测定 17例 1型糖尿病 (IDDM) ,其中初诊 8例 ;47例 2型糖尿病 (NIDDM) ,其中初诊 5例 ;2 1例初诊 NIDDM在口服降糖药治疗前后 ,及 2 8例健康志愿者的 Ins R活性。结果 与正常人相比 ,IDDM患者发病时 Ins R活性升高 ,用胰岛素治疗后降低 ;NIDDM患者虽不伴有高胰岛素血症 ,但 Ins R活性降低 ,经口服降糖药治疗后仅部分恢复。结论 经改良的 Ins R活性分析技术 ,简便实用 ,稳定可靠 ,更适合临床应用。 IDDM患者 Ins R活性改变系由于胰岛素的升降调节 ;NIDDM患者 Ins R活性降低则是多因素的 ,两者的病理生理机制不同。
Objective To study the changes of insulin receptor (Ins R) activity and its therapeutic effects in the pathogenesis of Type 1 and Type 2 diabetes mellitus (DM). Methods Seventeen cases of type 1 diabetes mellitus (IDDM) were diagnosed by modified R R activity radioimmunoassay. Among them, 8 cases were newly diagnosed, 47 cases were type 2 diabetes mellitus (NIDDM), of whom 5 cases were newly diagnosed; 21 cases were newly diagnosed with oral NIDDM Before and after the treatment of sugar, and 28 healthy volunteers Ins R activity. Results Compared with normal subjects, Ins R activity was increased in patients with IDDM and decreased after treatment with insulin. Although NIDDM patients were not associated with hyperinsulinemia, Ins R activity was decreased and only partially recovered after treatment with oral hypoglycemic agents . Conclusion The improved Ins R activity assay is simple and practical, stable and reliable, and more suitable for clinical application. The changes of Ins R activity in IDDM patients are regulated by the elevation of insulin. The decrease of Ins R activity in NIDDM patients is multifactorial, and their pathophysiological mechanisms are different.