儿童青少年糖尿病临床特征及初步分型探讨  

Clinical characteristics and primary classification for diabetes in children and adolescents.

作　　者：范元硕[1] 罗建华[1] 于瑞萍[1] 刘波[1] 龙本丹[1] 

机构地区：[1]贵州省人民医院内分泌科,贵州贵阳550002

出　　处：《海南医学》2013年第9期1304-1306,共3页Hainan Medical Journal

基　　金：贵州省优秀科技教育人才省长专项资金项目(编号:200760);贵州省社会发展攻关项目(编号:SY20083051);高层次人才科研条件特助经费项目(编号:TZJF200747)

摘　　要：目的探讨儿童青少年糖尿病患者的临床特征和初步分型。方法根据空腹C肽水平将36例儿童青少年糖尿病患者分为C肽降低组(空腹C肽<0.60μg/L,24例)和C肽正常组(空腹C肽≥0.60μg/L,12例),比较两组患者的临床资料。结果 C肽正常组黑棘皮症、2型糖尿病家族史、代谢综合征及超重/肥胖者的比例明显高于C肽降低组(P<0.01或P<0.05),体质指数、腰围、空腹C肽、餐后2hC肽及餐后C肽增加值水平明显高于C肽降低组(均P<0.01),谷氨酸脱羧酶抗体/蛋白酪氨酸磷酸酶抗体阳性率、并发酮症/酮症酸中毒及低体重者的比例明显低于C肽降低组(P<0.01或P<0.05),随机血糖及血β羟丁酸水平明显低于C肽降低组(P<0.01或P<0.05)。结论根据空腹C肽水平可对儿童青少年糖尿病患者初步分型,C肽降低组更倾向于1型糖尿病,C肽正常组更倾向于2型糖尿病。Objective To investigate the clinical characteristics and primary classification of diabetes in children and adolescents. Methods According to fasting C-peptide level, 36 children and adolescents with diabe- tes were divided into two groups： decreased C-peptide group （fasting C-peptide level〈0.60μg/L, n=24） and nor- mal C-peptide group （fasting C-peptide level≥0.60μg/L, n=12）. Clinical characteristics were compared between two groups. Results Compared with decreased C-peptide group, normal C-peptide group had significantly higher proportion of acanthosis nigricans, family history of type 2 diabetes, metabolic syndrome and overweight/obesity （P〈 0.01 or P〈0.05）. The levels of body mass index, waist circumference, fasting C-peptide, postprandial C-peptide and A C-peptide in normal C-peptide group were significantly higher than those in decreased C-peptide group （all P〈0.01）. The rate of positive glutamic acid decarboxylase antibody/protein tyrosine phosphate antibody, concurrent ketosis/ke- toacidosis and underweight in normal C-peptide group was significantly lower than that in decreased C-peptide group. （P〈0.01 or P〈0.05） Normal C-peptide group showed significantly lower levels in random blood glucose and β hy- droxybutyric acid than those in decreased C-peptide group （P〈0.01 or P〈0.05）. Conclusion According to fasting C-peptide level, children and adolescents with diabetes can be primary classified. Decreased C-peptide group is more likely to be classified as type 1 diabetes, and normal C-peptide group is more likely to be classified as type 2 diabetes.

关 键 词：糖尿病 儿童青少年 临床特征 分型 

分 类 号：R725.8[医药卫生—儿科]