四项基本临床试验在非胰岛素依赖型糖尿病优降糖继发失效时的应用

本文对２８例优降糖继发失效及２３例有效的非胰岛素依赖型糖尿病病人分别进行优降糖敏感性试验、胰岛素耐量试验、胰高糖素Ｃ肽刺激试验及标准馒头餐试验，比较两组病人试验结果的差异，分析失效组病人个体各项试验结果的特点，说明结合四项基本临床试验可从磺脲类药物抵抗性、胰岛素敏感性、Ｂ细胞贮备功能及葡萄糖介导的胰岛素分泌反应等不同环节，探讨磺脲类药物继发失效的原因及发生机理，分析个体病人的临床特征，指导治疗。

Application of four clinical tests in secondary sulfonylurea failure in NIDDM

Four clinical tests,including glybenclamide sensitivity test,insulin tolerance test,glucagon-stimulation test and standard steamed bread meal test,were performed in NIDDM patients,The results from 28 nonresponders (i.e,,sencondary sulfonylurea failure)were compared with those from 23 responders to glybenclamide therapy,and the results of four tests were further analyzed in individual patients,It is concluded that these clinical tests can be applied respectively to evaluate sulfonylurea resistance,insulin sensitivity,reserve capacity and glucose-mediated insulin release response of B cell in NIDDM patients,and,therefore,they ar helpful in studying the pathogenesis of secondary sulfonylurea failure and to direct the choice of treatment of individual patients.