胰岛自身抗体和生化指标在糖尿病分型诊断中应用价值.docVIP

胰岛自身抗体和生化指标在糖尿病分型诊断中应用价值 　　[摘要]目的 分析探讨针对糖尿病患者检测抗胰岛素抗体、抗胰岛细胞抗体、抗谷氨酸脱羧酶抗体的临床应用价值。方法 选取我院2013年8月～2016年8月收治的临床DM患者230例作为研究对象，检测患者的抗胰岛素抗体、抗胰岛细胞抗体、抗谷氨酸脱羧酶抗体。根据抗体阴性/阳性分为T1DM组和T2DM组，分别比较两组的空腹葡萄糖、空腹胰岛素及空腹C肽浓度。结果 T1DM组患者的IAA-Ab、ICA-Ab以及GAD-Ab阳性率明显高于T2DM组，差异有统计学意义（P0.05）。结论 糖尿病患者检测自身抗体，对糖尿病的早期诊断、分型和治疗有很大的指导意义。 　　[关键词]抗胰岛细胞抗体；抗胰岛素抗体；抗谷氨酸脱羧酶抗体；糖尿病 　　[中图分类号] R587.1 [文献标识码] A [文章编号] 1674-4721（2017）08（c）-0112-03 　　[Abstract]Objective To analyze and discuss the clinical application value of detection islet cell antibodies，anti-insulin antibodies and glutamic acid decarboxylase antibodies in the diagnosis of diabetes mellitus.Methods 230 cases of clinical diabetes mellitus patients admitted to our hospital from August 2013 to August 2016 were selected as the study subjects.The indexes of islet cell antibodies，anti-insulin antibodies and glutamic acid decarboxylase antibodies were detected.The T1DM group and T2DM group were divided according to antibody negative/positive classification，the FBG，INS and CP concentrations of two groups were observed.Results The positive rate of islet cell antibodies，anti-insulin antibodies and glutamic acid decarboxylase antibodies of patients in T1DM group was significantly higher than that in T2DM group，and the differences were statistically significant （P0.05）.Conclusion For diabetes mellitus patients，the detection of insulin autoantibodies have great guiding significance in the early diagnosis，typing and treatment. 　　[Key words]Islet cell antibodies；Anti-insulin antibodies；Glutamic acid decarboxylase antibodies；Diabetes mellitus 　　糖尿病（diabetes mellitus，DM）是?R床常见的慢性疾病，随着我国居民饮食习惯和生活习惯的改变，糖尿病发生率逐渐升高，引起相关专家学者的关注和重视。目前糖尿病分为1型糖尿病（Type 1 diabetes mellitus，T1DM）、2型糖尿病（Type 2 diabetes mellitus，T2DM）和妊娠期糖尿病等[1]。其中以T2DM最为常见，占糖尿病总数的90%以上。T1DM次之，占5%～10%[2]。随着研究的深入，人们发现T1DM主要是由于胰岛β细胞功能缺失导致胰岛素分泌绝对缺乏所致[3]。T2DM则是以胰岛素抵抗或胰岛素分泌相对不足为主要表现的糖尿病。虽然目前临床上对T1DM和T2DM的诊断主要依据是其临床表现、年龄、体质指数（BMI）等，但由于病情的复杂化以及发病人群的多样化，使糖尿病分型更加困难[4-5]。因此，本研究以230例DM患者作为研究对象，对糖尿病患者进行胰岛自身抗体和生化指标检测