【摘要】 目的 :研究胰岛自身抗体测定对 2型DM病的临床意义。方法 :对 5 2 8例 2型糖尿病 (DM)患者中胰岛细胞抗体阳性者 95例 ,其中谷氨酸脱羧酶 (GAD)抗体阳性 39例 ,胰岛细胞抗体 (ICA)阳性 5 6例 ,两者均阳性 15例 ,并根据其空腹血糖和胰岛细胞功能分为轻、中、重 3组 ,测定其最高BMI及目前BMI、FBG及空腹和糖负荷后 6 0min、12 0min、180minC肽水平。同时根据各组发病年龄、病理、酮症 酸中毒发生情况等临床资料进行统计分析。结果 :①GAD抗体中度组阳性检出率高于轻度组 ,P <0 .5重度组阳性检出率明显高于轻中度组 ,P <0 .0 1。②ICA测定中度组阳性检出率高于轻度组 ,P <0 .0 5 ,重度组则显著高于轻度组 ,P <0 .0 1。③中重度组平均FBG显著高于对照组 ,P <0 .0 5 ,而空腹血糖负荷后 6 0min、12 0min、180minC肽水平则显著低于对照组 ,P <0 .0 5 ,轻度组与对照组相比 ,C肽无显著临床意义 (P >0 .0 5 )。④重度组发病年龄较中、轻度组 (P <0 .0 1)病程及体重亦降低 (P <0 .0 5 ) ,而轻度组与对照组相比无显著差异 (P >0 .0 5 ) ,酮症 酸中毒发生率重度组明显高于轻、中度组及对照组 (P <0 .0 1)。结论 :临床上诊断为 2型DM患者相当一部分可视为成人晚发性自身免疫性糖尿病 (LADA)。GAD抗体及ICA测定有助于更多还原

【Abstract】 Objective:To study the clinical significance of islet autoantibodies in type 2 DM.Method:95 patients of type 2 DM who have positive islet autoantibodies were divided into mild,medium and severe groups by fasting blood glucose and function of islet.The highest BMI,present BMI,fasting blood glucose,C peptide in fasting for 60 min,120 min,180 min and other clinical data were Analysed.Results:①The positive rate of GAD and ICA antibodies in the severe group was significantly higher than that in the mild group( P <0.01).②The level of C peptide in fasting for 60 min,120 min,180 min in the medium and severe group were significantly lower than those in controls( P <0.05).③Episode,age,progress,body weight in the severe group were significantly lower than those in the mild group( P <0.05).The incidence of ketoacidosis in the severe group was significantly higher than that in other groups( P <0.01).Conclusions:Some type 2 DM clinically diagnosed may be LADA and the detect of GAD and ICA antibodies had an important clinical value in typing DM,treatment of insulin and judgement of prognosis.更多还原