网信彩票

1,5-tuoshuiputaotangchunyoucheng1,5 - tuoshui - d - shanlichun（1,5 - anhydro - d - glucitol，1,5 - ag）shiyoubinantanghuanzhuangjiegoudiyiweitantuoyangsuoxingcheng，guyoucheng1 - tuoyangputaotang( 1 - deoxyglucose，1 - dg )，zhuyaocunzaiyurennaojiye、xueqing、gezuzhizangqizhong【1】 。rentizhengchangqingkuangxia1,5 - agbaochiwending，zhengchangxiaxianwei85. 26 μmol/l。1,5 - ag zaitangniaobinghuanzhexueqingzhongxianzhujiangdi，jiangdichengduyuhuanzhezhengzhuangdeyanzhongchengduyouguan。xianyizhengshi，1,5 - agshijixuetang、24xiaoshiniaotangdingliang、guotangan(huotanghuabaidanbai)、tanghuaxuehongdanbai(hba1c)zhihoudeyouyixinde、lingmindugaode、pojuqianjingdetangniaobingbingqingjiancezhibiao，sheneryouwangkezuoweitangniaobingshaixuanjizhenduandeshouduan【2】 。

一、1,5-AG结构

1,5 - agshiyoubinantangc1 weishangdeo hjihaiyuansuoxingcheng，shuduoyuanchundeyizhong，jiegouleisiputaotanghuoshanlitangchun，rutu1suoshi。

1,5-AG化学结构

二、1,5-AG的来源、分布及代谢

体内1,5 - AG主要来源于食物，正常人每天平均从食物中获得5 - 10mg，食入后通过小肠迅速吸收，吸收后经过血液循环分布于各组织、脏器。从食物中摄入的1,5 - AG会从尿液中排出，摄入的1,5 - AG与尿排出的1,5 - AG形成了一个平衡，且其日吸收量与日排量成正比。在体内1,5 - AG有一个庞大的代谢池，很少被降解或代谢，总含量维持在500 - 1000mg【3】 。因此血液中的1,5 - AG浓度不受进食、忌食、肥胖、运动、应激及服用各种药物等多种因素的影响，非常稳定。
yanjiubiaoming，zhengchangrenmeitianshenxiaoqiulvguo1,5 - agliangyue3500mg，danshijishangcongniaoyepaichuliangyue5 - 10mg，qiyuanyinshi1,5 - agyoushenxiaoqiulvguohou，juedabufen（99.9%）beishenxiaoguanzhongxishoufanhuixueye。

三、糖尿病患者1,5-AG水平降低的机理

shiyanzhengming，suizhetangniaobingbingqingjiazhonghuohuanjie，1, 5 - agzhijiangdihuohuisheng，bingqingyu1, 5 - agchengfuxiangguan。tangniaobingshixuezhong1,5 - agxianzhujiangdidejizhirutuersuoshi：zaiyutangniaobinghuanzhexuezhongputaotangliangzengduo，1,5 - agshuyuleiputaotangwuzhi，gaotangzhuangtaixialvchudedaliangputaotangyu1,5 - agzaijinquxiaoguanjingzhengxingzhongxishou，youyuniaotangpaichuguoduoeryingxiang1,5 - agdezhongxishou，niaozhongpaichuliangzengjia，zaocheng1,5 - agdehaosun，birandongyongxueyexunhuanzhongdechubei，daozhixuezhongnongdujiangdi，shixuezhong1,5 - agshuipingmingxianxiajiangbingyukongfuxuetangchengmingxianfuxiangguan。yanjiuxianshi，shiyanxingtangniaobingdabaishuxuetangzenggaodetongshi，xueyejigezuzhizhongde1,5 - agjizhoujianshao，jiangshenzangzhaichuhourengyougaoxuetang，danxuezhong1,5 - agbingbujianshao，zhengming1,5 - agpaichuyushenzangyouzhijieguanxi。suoyi，zaipaichushengongnengbuquandeqingkuangxia，1,5 - agkezuoweitangniaobingzhenduanhejiankongdekekaozhibiao。

血中1,5-AG循环机理

四、1,5-AG的临床意义

1. 可作为糖尿病诊断的可靠指标

zhengchangqingkuangxia，l,5 - agbaochijiaoweijunhengdewendingzhuangtai，bushouxingbie、nianling、yinshi、feipang、yundong、yingjijifuyonggezhongyaowudengdeyingxiang，yebushouzhifangdaixie、gangongneng、shengongneng、yidaosuzhiwaideqitajisuyingxiang，erqietangniaobingshiqinongdubianhuaminrui，zaipaichushengongnengbuquandeqingkuangxia，l,5 - agkezuoweitangniaobingzhenduandekekaozhibiao。yukongfuxuetanghetanghuaxuehongdanbailianheceding，duitangniaobingdezaoqizhenduangengyouyiyi。lingwai，beirenweishijinbiaozhundetangnailiangshiyanbushiyongyudapiliangrenqundechangguishaicha，bulunshi1xinghuo2xingtangniaobing，yebulunshixinquezhenhuozhejiwangtangniaobinghuanzhe，xueqingzhongl,5 - agjunjiangdi。suoyi，l,5 - aghaikezuoweitangniaobingzhenduandeshaichazhibiao 【4】。

2. 弥补糖尿病现有监测指标的不足

kongfuxuetang、tanghuaxueqingdanbai、tanghuaxuehongdanbaifenbiedaibiaojishi、jin2~3zhouhejin2~3geyuedexuetangkongzhishuiping，erquefajinjitiandexuetangjiancezhibiao。1,5 - agfanyingjinjitianzhi1zhoudexuetangshuiping，mibuletangniaobingjiancezhibiaodebuzu。tanengzhunquedijiancexuetangdeweixiaobianhua，ermeiyouyanchishijian，duixuyaoyangekongzhixuetangdedebingrenlaishuo，zheigezhibiaogengjiashihe 【4】。

3. 可作为评价糖尿病治疗效果的指标

zaiyidaosuyilaixingtangniaobingjixingfabingshi，l,5 - agshouxianchuxiandizhi，suizhebingqingfazhanjibingchengdetuiyi，caixiangjichuxiantanghuaxueqingdanbai、tanghuaxuehongdanbaiyichang，dangbingqingzhujianhaozhuanhou，l,5 - agyoushouxianshenggao，jiyishengyizuizaodexinxi，youzhuyujishidiaozhengzhiliaofangan。youyu1,5 - agnengxunsufanyingxuetangshuiping，yinciyekeyongyujiangtangyaoguoliangyinqidedixuetangdeyufangxingjiancezhibiao。zailinchuanghaiweichuxiandixuetangzhengzhuangshi，1,5-ag yixunsuchuxiangaozhi，tishiyingjishidiaozhengyidaosuhuoqitajiangtangyaowudeyongliang，bimianchuxianlinchuangdixuetang【4】 。

4. 可作为糖尿病肾损害的指标

糖尿病、肾病病人尿中N - 乙酰氨基葡萄糖苷酶（NAG）和微量白蛋白（MA）含量升高，与血浆l,5 - AG水平呈负相关，当血浆l,5 - AG上升时，尿NAG即下降，在肾功能损害尚不严重时，l,5 - AG水平可预测高血糖所导致的可逆性肾损害，这种预测的准确性就像预测血糖的严重性一样准确【4】。

参考文献：
【1】李玉运. 1,5-脱水山梨醇的测定及其应用研究[D]. 天津：天津医科大学，2007.
【2】 Masafumi Koga. 1,5-Anhydroglucitol and Glycated Albumin in Glycemia [J]. Advances in clinical chemistry 64（7）（2014）269-301.
【3】邱文生. 1,5-脱水山梨醇的基础与临床[J]. 中国糖尿病杂志，1997，5（2）：104-106.
【4】yangwenyong. youyizhongtangniaobinghuayanzhibiaojiao1,5-tuoshuishanlichun[j].tangniaobingxinshijie，2011，（9）.