免疫学指标和临床特征对成人隐性自身免疫性糖尿病的诊断比较  

THE DIAGNOSTIC COMPARISON OF IMMUNE MARK AND CLINICALCHARACTERISTICS IN LATENT AUTOIMMUNE DIABETES IN ADULTS

作　　者：丁奇龙[1] 李晓萍[1] 杜群[1] 刘文豹[2] 康妙云 

机构地区：[1]内蒙古医学院第三附属医院内分泌科,内蒙古包头014010 [2]内蒙古医学院第三附属医院核医学科,内蒙古包头014010

出　　处：《内蒙古医学院学报》2002年第2期90-92,共3页Acta Academiae Medicinae Neimongol

摘　　要：目的 :比较临床代谢特征和免疫学标记对诊断成人隐性自身免疫性糖尿病 (LADA)的一致性。方法 :选用 1 空腹血糖≥ 15mmol/L ;2 .餐后 2h血糖≥ 2 2mmol/L ;3 .空腹血C -P≤ 0 4nmol/L ;4.餐后 2hC—P≤ 0 6nmol/L ;5 .体重指数 (BMI)≤ 2 2kg/m2 ;6 自发性酮症作为LADA的临床分型标准 ,符合其中 4项者定为LADA ,其余属Ⅱ型糖尿病 ,结果与根据谷氨酸脱羧酶抗体 (GAD -ab)的分型结果相比较 ,了解两者的一致性。结果 :116例成人初发糖尿病人 ,临床分型属LADA 15例 ,其中GAD—ab阳性 12例 ,阳性率 80 % ,10 1例Ⅱ型糖尿病有 2例GAD—ab阳性 ,阳性率 2 % ,除餐后 2h血糖≥ 2 2mmol/L在两组之间无差异外 ,其余各项指标在两组间均存在显著性差异。结论 :依据临床代谢指标和免疫学标记所做的分型一致性较好。可用于临床识别LADA。Objective:To investigate the accordance of diagnosis LADA in clinical matabolism characteristics and immune mark.Methods:To select 1.fasting plasma glucose≥15 mmol/L,2.postprandial 2-h plasma glucose≥22 mmol/L,3.fasting C-P≤0.4 nmol/L,4.postprandial 2-h C-P≤0.6 nmol/L,5.body mass index(BMI)≤22 kg/m 2,6.spontaneous ketosis.The above six items are regarded as classification standard of LADA.The one which conform to four items is determined as LADA.The others are type Ⅱ diabetes.To compare this kind of classificaion and GAD-ab classification,and investigate the accordance of these two methods.Results:Among 116 diabetes patients,15 patients diagnosed with LADA,and 12 GAD-ab + patients.Positive rate covers 80%.There are 2 GAD-ab + patients among 101 type Ⅱ diabetes patients,positive rate covers 2%.There are obvious differences of these parameters between two groups except for the parameters of postprandial 2-h plasma glucose≥22 mmol/L.Conclusion:The classification according to clinial metabolism characteristics and GAD-ab has very high accordance.This method can be used to recognize LADA.

关 键 词：成人隐性自身免疫性糖尿病 谷氨酸脱羧酶 诊断 

分 类 号：R587.104[医药卫生—内分泌]