这些药物影响OGTT结果,检查糖耐量前需停药!

2018-05-08 金丽 上海药讯

笔者在实践工作时发现临床医生、检验科与我们的药师对口服葡萄糖耐量试验(OGTT)的葡萄糖用量及药物对OGTT试验的影响等问题存在认识上差异。


作者:上海市东方医院  金丽 

笔者在实践工作时发现临床医生、检验科与我们的药师对口服葡萄糖耐量试验(OGTT)的葡萄糖用量及药物对OGTT试验的影响等问题存在认识上差异。

OGTT是临床诊断糖尿病的一种常用方法,因此有必要对一些细节问题予以说明。

1、何谓「OGTT」?

OGTT是一种葡萄糖负荷试验,可以检测机体对血糖的调节能力,判断受检者是否存在糖调节异常及糖尿病

对于正常人即使一次性摄入大量的糖分,血糖浓度也只是暂时性轻度升高,并且很快(2-3 小时)可恢复到正常水平,这种现象称为耐糖现象。

当体内存在胰岛素抵抗(IR)和/或胰岛素分泌异常时,机体对糖的吸收、利用能力下降,在服用一定量的葡萄糖后,血糖浓度则会显著升高,并且短时间内不能恢复至正常水平。

2、OGTT对葡萄糖用量的要求是多少?

《中国2型糖尿病防治指南(2013版)》附录8明确规定OGTT方法:

晨7~9时开始,受试者空腹(8~10小时)后口服溶于300毫升水内的无水葡萄糖粉75克,如用1分子水葡萄糖则为82.5克;儿童则予每克体重1.75克,总量不超过75克;糖水在5分钟之内服完。

如何区分无水和1分子葡萄糖呢?市售“葡萄糖”粉和葡萄糖注射液(20ml:10g)说明书提示:成分为D-(+)-吡喃葡萄糖一水合物,因此市售“葡萄糖”粉用量为82.5克;50%葡萄糖注射液也应为82.5克葡萄糖,即取165毫升50%葡萄糖注射液加水至300毫升口服。

3、哪些药物会影响OGTT结果?

以下药物造成血糖波动,为排除药物对OGTT的影响,检查前应停药3天以上:

可使血糖增高的药物

噻嗪类、糖皮质激素、醛固酮、肾上腺素、去甲肾上腺素、速尿、女性避孕药、消炎痛、氯丙嗪、苯妥英钠和生长激素等。

可使血糖下降的药物

磺脲类、双胍类、对氨水杨酸、异烟肼、单胺氧化酶抑制剂、抗甲状腺药物、 水杨酸、心得安、丙磺舒等。

试验过程中,患者不喝茶及咖啡、不吸烟、不做剧烈运动;检查前3d内,每日碳水化合物摄入量不少于150g。实验过程中不得进食,但不绝对限制饮水,口渴时可以适量喝少量白开水(起到润喉作用即可);试验中如果口服糖水后出现呕吐,应择日再做。

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    2018-05-10 shenxlcyp
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    2018-05-10 yinhl1980
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    2018-05-10 fengxx
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    2018-05-08 王秀

    学习了.涨知识了!

    0

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    2018-05-08 wqkm

    ^_^^_^^_^

    0

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    2018-05-08 1e0f8808m18(暂无匿称)

    好文章.学习了.

    0

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