急性胰腺炎患者血浆C肽和胰高血糖素的水平及意义

目的测定急性胰腺炎患者血浆中胰岛分泌C肽(CP)和胰高血糖素(GG)的水平,探讨胰岛内分泌细胞的功能变化。方法采用放射免疫分析法测定84例急性胰腺炎患者(其中重型急性胰腺炎24例,轻型急性胰腺炎60例)和40例急性胆囊炎患者(对照组)血浆中CP和GG水平。比较各组患者CP和GG水平的变化,判断胰岛A、B细胞的功能。结果重型急性胰腺炎组患者CP水平于发病后第6天、第9天、第12天明显低于对照组(P<0.05),GG水平于发病后第9天、第12天明显低于对照组(P<0.05)。轻型急性胰腺炎组患者CP和GG的水平与对照组比较差异无统计学意义(P>0.05)。结论(1)重型急性胰腺炎时胰岛内分泌细胞受到破坏,血浆中CP、GG水平降低;CP能准确、及时地反映胰岛B细胞受损程度。(2)GG水平可以反映胰岛A细胞功能,重型急性胰腺炎时B细胞可能比A细胞更早受到破坏。

Variety and significance of serum C peptide and glucagon in patients with acute pancreatitis

Objective To investigate the levels of C peptide and glucagon in patients with acute pancreatitis, to exhibit the function of islet endocrine cells. Methods The levels of C peptide and glucagon in 84 patients with acute pancreatitis and in 40 patients with acute cholecystitis were tested by radio immunomassay method. According to the levels of C peptide and glucagon, the function of islet A cells and B cells were exhibited. Results The level of C peptide in patients with severe acute pancreatitis was significantly lower than those in patients with acute cholecystitis at 6th, 9th and 12th day after the invasion(P<0.05),and the level of glucagon was lower at 9th and 12th day after the invasion (P< 0.05 ). There was no significant difference in above maker between the patients with mild acute pancreatitis and acute cholecystitis. Conclusion The islet endocrine cells are injured in the patients with severe acute pancreatitis, the levels of C peptide and glucagons are able to exhibit the function of islet B cells and A cells. C peptide is accurate and punctual to reflect the degree of impaired B cells. The level of glucagons is able to exhibit the function of A cells. The islet B cells are susceptible to be damaged in severe acute pancreatitis.