一.臨床意義

C肽（C-Peptide）又稱連接肽，是胰島β細(xì)胞的分泌產(chǎn)物，它與胰島素有一個(gè)共同的前體—胰島素原。一個(gè)分子的胰島素原經(jīng)酶切后，裂解成一個(gè)分子的胰島素和一個(gè)分子的C肽。正常情況下，人胰島細(xì)胞主要分泌產(chǎn)生并釋放到血液中的是胰島素，在產(chǎn)生胰島素的一系列的過程中，胰島細(xì)胞首先合成胰島素原。胰島素原是一條很長的蛋白質(zhì)鏈，胰島素原在酶的作用下被分解為三段，前后兩段又重新聯(lián)接，成為有A鏈和B鏈組成的胰島素，中間一段獨(dú)立出來，稱為C肽。

C肽與胰島素以等分子數(shù)共存于分泌顆粒并同時(shí)釋放至毛細(xì)血管循環(huán)中，且C肽不被肝臟破壞，半壽期較胰島素明顯為長，故測(cè)定血循環(huán)中c肽水平能反映β細(xì)胞合成與釋放胰島素功能。C肽的測(cè)定，有助于糖尿病的臨床分型，胰島細(xì)胞瘤的診斷及判斷胰島素瘤手術(shù)效果,判定患者的胰島β細(xì)胞功能，鑒別低血糖的原因等。測(cè)定血清C肽的水平可以了解胰島的分泌、代謝和胰島B細(xì)胞的儲(chǔ)備功能。

二.參考文獻(xiàn)

1. Ashby, J. and Frier, B.: Circulating C-Peptide: Measurement and Clinical Applications.Annals of Clinical Biochemistry. 18:125, 1981
2. Beischer, W.: Proinsulin and C-Peptide in Humans. Hormones in Normal and Abnormal Human issues. Volume 3K, Fotherby and Pal, S., ed. (Berlin: Walter DeGruyter). pp. 1-43, 1983
3. Beyer, J., Krause V., Cordes V.: C-Peptide: Its Biogenesis, Structure, Determination and Clinical
Significance. Giornale Italiano di Chimica Clinica 4 Supp. 9:22, 1979
4. Bonger, A. and Garcia-Webb, P.: C-Peptide Measurement: Methods and Clinical Utility.CRC Critical Reviews in Clinical Laboratory Sciences. 19:297, 1984.
5. Blix, P. Boddie-Wills, C., Landau, R., Rochman, H. Rubenstein, A.: Urinary C-Peptide: An Indicator
of Beta-Cell Secretion under Different Metabolic Conditions.
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6. Rendell, M.: C-Peptide Levels as a Criterion in Treatment of Maturity-Onset Diabetes.Journal of Clinical Endocrinology and Metabolism. 57 (6): 1198, 1983
7. Horwitz, D., et al.: Proinsulin, Insulin and C-Peptide concentrations in Human Portal and Peripheral
Blood. Journal of Clinical Investigation. 55:1278, 1975
8. Horwitz, D., Kurzuya, H., Rubenstein, A.: Circulating Serum C-Peptide.The New England Journal of Medicine. 295:207,1976
9. Rendell, M.: The Expanding Clinical Use of C-Peptide, Radioimmunoassay.Acta Diabetologica Latina. 20:105, 1983
10. Heding, L. and Rasmussen, S.: Human C-Peptide in Normal and Diabetic Subjects.Diabetologica. 11:201, 1975
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12. Starr, J., Horwitz, D., Rubenstein, A., Mako, M.: Insulin, Proinsulin and C-Peptide. Methods of
Hormone Radioimmunoassay 2nd Ed., Academic Press Inc., 1979
13. Rubenstein, A., Kuruya, H., Horwitz, D.: Clinical Significance of Circulating C-Peptide in Diabetes
Mellitus and Hypoglycemic Disorders. Archives of Internal Medicine. Vol. 137:625, May 1977.
14. Yalow, R., Berson, S.: Introduction and General Considerations. Principles of Competitive Protein
Binding Assays. Ch. 2, Eds. Odell, W. and Daugheday, W., J.B. Lippincott Co., Philadelphia, 1971

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