【摘要】 目的　对９８４ 例糖尿病患者的胰岛细胞抗体（ＩＣＡ） 、谷氨酸脱羧酶抗体（ＧＡＤＡ） 和血清Ｃ肽进行了检测与分析，了解ＩＣＡ 和ＧＡＤＡ 阳性率以及阳性患者的胰岛功能情况，以明确ＩＣＡ 和ＧＡＤＡ检测对１ 型糖尿病早期诊断的意义。方法　采用免疫组化法检测ＩＣＡ，ＥＬＩＳＡ 法定量检测ＧＡＤＡ， 放射免疫法检测血清空腹和餐后Ｃ 肽。结果　ＩＣＡ 和（或）ＧＡＤＡ 阳性（ 阳性组）１６８ 例（１７ ．０％ ） 高于ＩＣＡ 阳性率（１０．５ ％） 和ＧＡＤＡ 阳性率（１２．０ ％ ，Ｐ＜ ０ ．０５） 。成年患者ＧＡＤＡ 阳性率（１０ ．５％ ） 高于ＩＣＡ（７．７ ％ ， Ｐ＜ ０ ．０５） ， 青少年患者ＩＣＡ 阳性率（４６．５ ％） 高于ＧＡＤＡ（３１．０％ ，Ｐ＜０．０１）。抗体阳性患者的空腹和餐后Ｃ肽〔（３２５ ±３６８）ｐｍｏｌ／Ｌ和（７４５±７６７）ｐｍｏｌ／Ｌ〕明显低于抗体阴性患者〔（７０１ ±４３４）ｐｍｏｌ／Ｌ和（１ ６１４ ±９６７）ｐｍｏｌ／Ｌ，Ｐ＜０ ．００１〕。结论　自身抗体阳性患者的胰岛功能明显低于阴性患者，提示自身抗体阳性患者胰岛功能有明显损伤。在成年糖尿病患者中ＧＡＤＡ检测较ＩＣＡ 更为重要，而在青少年糖尿病患者中则ＩＣＡ阳性更多还原

【Abstract】 Objective To evaluate the significance of islet cell antibody (ICA) and glutamic acid decarboxylase antibody (GADA) determination in the early diagnosis of type 1 diabetes mellitus, ICA, GADA and serum C peptide of 984 patients with diabetes mellitus were measured and analysed. Methods ICA was determined with immunohistochemical method, GADA with enzyme linked immunosorbent assay and serum C peptide with radioimmunoassay. Results The positive rate of ICA and(or) GADA (positive group) was higher than that of ICA (17.0% versus 10.5%, P<0.05) and that of GADA (17.0% versus 12.0%, P<0.05). In adult diabetics, the positive rate of GADA was higher than that of ICA (10.5% versus 7.7%, P<0.05), while in juvenile diabetics, the positive rate of ICA was higher than that of GADA (46.5% versus 31.0%, P<0.01). Fasting and postprandial C peptide of antibody positive diabetics 〔(325±368)pmol/L and (745±767)pmol/L〕 were significantly lower than those of antibody negative diabetics 〔(701±434)pmol/L and (1614±967)pmol/L〕, P<0.001. Conclusion The islet function of diabetics with positive antibodies was significantly lower than that of diabetics with negative antibodies, indicating that in the former islet function was markedly damaged. The assay of GADA was more important than ICA in adult diabetics and the positive rate of ICA in juvenile diabetics was higher than that of GADA. The combined determination of GADA and ICA may enhance the sensitivity of diagnosis, having an important significance for early diagnosis of type 1 diabetes mellitus.更多还原