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目的 探讨和评价儿童糖尿病血清学分型诊断方法的临床应用价值。 方法 选择临床确诊的儿童糖尿病患者 2 76例 ,空腹静脉采血进行谷氨酸脱羧酶 (GAD)抗体和抗胰岛细胞 (ICA)抗体测定 ,同时检测血糖、尿糖、糖耐量等项目。 结果 在Ⅰ型儿童糖尿病组中 ,GAD和ICA抗体阳性检出率明显高于Ⅱ型糖尿病组 ( χ2 =2 13.94,P <0 .0 1;χ2=184.86 ,P <0 .0 1) ,两抗体阳性检出率差异无显著意义 ( χ2 =10 .31,P >0 .0 5 ) ,但具有一定程度的统计学相关性 ( χ2 =33.2 3,P <0 .0 1,r =0 .8479) ;而在Ⅱ型儿童糖尿病组中 ,两抗体阳性检出率差异无显著意义 ( χ2 =1.45 ,P >0 .0 5 ) ,也无统计学相关性 ( χ2 =0 .0 8,P >0 .0 5 )。 结论 GAD和ICA抗体可单独作为糖尿病分型诊断的指标 ,两法联合检测并结合其他血清、临床流行病学资料 ,将有助于糖尿病的预测、早期分型诊断、指导临床用药和高危人群的筛查。
Objective To investigate and evaluate the clinical value of serological typing in children with diabetes mellitus. Methods Two hundred and seventy-six children with clinically diagnosed childhood diabetes were selected. Fasting venous blood was collected for the determination of GAD and ICA antibodies. Blood glucose, urine glucose and glucose tolerance were measured. Results The positive rate of GAD and ICA antibodies in type I children with diabetes mellitus was significantly higher than that in type II diabetic patients (χ2 = 2 13.94, P <0.01; χ2 = 184.86, P <0.01) The positive rate of antibody was not significantly different (χ2 = 10.31, P> 0.05), but with a certain degree of statistical correlation (χ2 = 33.23, P <0.01, r = 0. 8479). There was no significant difference in the positive rate of the two antibodies between type 2 children with diabetes (χ2 = 1.45, P> 0.05) (χ2 = 0.80, P > 0 .0 5). Conclusions GAD and ICA antibodies can be used alone as an index for the diagnosis of diabetes mellitus. Combined with other serum and clinical epidemiological data, the combination of the two methods will be helpful for the prediction of diabetes, early diagnosis of type, clinical guidance and high-risk population Screening.