2型糖尿病儿童8例临床分析及综合治疗随访  

Clinical Analysis and Follow-Up of Combined Therapy on 8 Cases of Type 2 Diabetes Mellitus

作　　者：潘佳容[1] 王秀敏[1] 梁黎[1] 李筠[1] 

机构地区：[1]浙江大学医学院附属儿童医院内分泌科,杭州310003

出　　处：《实用儿科临床杂志》2008年第20期1587-1589,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨2型糖尿病(T2DM)儿童的临床特点及诊治方法。方法对2002年5月-2008年2月本院8例住院T2DM患儿的临床资料进行回顾性分析,包括临床症状、体质量指数、血压、血脂、合并症、家族史、口服葡萄糖耐量试验、胰岛素释放试验。予饮食、运动、行为纠正和药物综合治疗及疗效随访。结果8例中仅1例有典型症状;均为肥胖儿,体质量指数为31.4±2.7;并脂肪肝7例,并原发性高血压、代谢综合征各4例,并高三酰甘油血症、黑棘皮病各3例,并酮症酸中毒1例;4例有肥胖家族史;3例通过饮食、运动和行为纠正治疗2个月后血糖有效控制,1例予胰岛素治疗1周后改为二甲双胍,余服用二甲双胍,2周后血糖有效控制。结论儿童T2DM起病隐匿,肥胖症是其重要危险因素,易并原发性高血压、脂质代谢异常、血管病变及靶器官损伤,需采取饮食、运动和药物治疗、教育及自我监控相结合的综合治疗措施。Objective To explore the clinical characteristics and therapy of type 2 diabetes mellitus （T2DM） in children. Methods The clinical data of 8 inpatients （aged from 12 years to 16 years）with T2DM from May. 2002 to Feb. 2008 were retrospectively analyzed, including their clinical presentation, body mass index （ BMI ）, blood pressure, blood triglyceride, complications, family history, oral glucose tolerance test results, insulin release test results, efficacy and follow - up of combined therapy of diet, exercise, correcting behavior and pharmaco- therapy. Results There was only one case presented with typical symptoms. All cases presented with obesity, with BMI 31.4 ± 2.7. High frequency of complications occurred in these cases,7 cases with adiposis hepatica,4 cases with hypertension,4 cases with metabolic syndrome,3 cases with hypeariglyeeridemia ,3 cases with acanthosis nigricans, 1 case with ketoacidosis. Four cases had positive obesity family history. Blood sugar was under control in 3 cases after 2 months of diet,exercise and correcting behavior. One case with ketoacidosis was treated with insulin for 1 week and metformin subsequently. Blood sugar was under control in all 5 cases treated with metformin after 2 weeks. Conclusions There is usually atypical symptoms occuring in T2DM in children. Obesity is one of the highest risk factors in this disease, frequently complicated with hypertension,abnormalities of lipids metablism, vascular lesion and target organ injuries. Treatment of T2DM in adolescents is complex and based on different strategies：diet,exercise ,pharmacotherapy, education and self- monitoring.

关 键 词：2型糖尿病 肥胖 二甲双胍 儿童 

分 类 号：R725.8[医药卫生—儿科]