酮症倾向糖尿病患者的临床特征及分型.docVIP

精品论文 参考文献 酮症倾向糖尿病患者的临床特征及分型 湖南省人民医院[湖南师范大学第一附属医院]内分泌科 湖南长沙 410005 【摘 要】目的 探讨酮症倾向糖尿病患者的临床特征及分型。方法 将40例自发糖尿病酮症或糖尿病酮症酸中毒起病的患者根据胰岛自身抗体阳性与否、体重指数分为抗体阳性组、抗体阴性的肥胖组、抗体阴性的非肥胖组，三组之间两两比较在起病年龄、性别、体重指数、血糖、血酮、血压、血脂、糖化血红蛋白及胰岛功能等方面的差异。结果（1）抗体阳性组无论是与抗体阴性的肥胖组还是与抗体阴性的非肥胖组相比，发病年龄轻，收缩压、舒张压、体重指数、甘油三酯、空腹C肽、餐后2小时C肽均降低，酮症或酮症酸中毒较抗体阴性的肥胖组和非肥胖组重，差异有统计学意义（Plt;0.05）。（2）抗体阴性的肥胖组空腹C肽、餐后2小时C肽均比抗体阴性的非肥胖组高???差异有统计学意义（Plt;0.05）。结论 酮症倾向的糖尿病存在一定的异质性，自发酮症或酮症酸中毒起病的肥胖糖尿病具有2型糖尿病的临床特征，可考虑分型为酮症倾向2型糖尿病。 【关键词】糖尿病；酮症；肥胖；临床特征 Abstract Objective To investigate the clinical characteristics and classification of patients with ketosis-prone diabetes.Methods According to antibody positive or and body mass index（BMI），patients were divided into three groups：antibody positive group（n=5），antibody negative obese group（BMIge;25kg/m2，n=16）and antibody negative nonobese group（BMIlt;25kg/m2，n=19）.Clinical characteristics，including age，sex，family history，BMI，blood glucose，blood ketosis，blood pressure，Triglyceride，total cholesterol and islet beta-cell function，were compared among three groups.Results Compared with whether antibody negative obese group or antibody negative nonobese group，the antibody positive group has lower age；the systolic pressure，diastolic pressure，body mass index，triglyceride，fasting C peptide and postprandial two hours peptide are lower in the antibody positive group；Ketosis or ketoacidosis in the antibody positive group is severer than that in the antibody negative obese group or the antibody negative nonobese group，the difference is of significance in statistics science.Fasting C peptide and postprandial two hours peptide in the antibody negative obese group are higher than that in the antibody negative nonobese group，the difference is of significance in statistics science.Conclusion Ketosis-prone diabetes is a heterogeneous disease，the obese patients with unprovoked ketosis or diabetic ketoacidosis may be classified as ketosis-prone type 2 diabetes because of clinical characteristics of type 2