糖尿病血清学分型诊断的临床实验研究

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目的:探讨和评价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357例糖尿病患者,空腹静脉采血进行抗胰岛细胞(ICA)抗体和谷氨酸脱羧酶(GAD)抗体测定,同时检测血糖、尿糖、糖耐量等其它项目。结果:ICA和GAD抗体测定对Ⅰ型糖尿病阳性检出率均高于Ⅱ型(X~2=259.86,P<0.01;X~2=288.16,P<0.01),Ⅱ。型糖尿病与对照组两法阳性检出率间均无显著性差异(X~2=2.89,P<0.05);同型糖尿病两法阳性检出率均无显著性差异(X~2=0.9,P>0.05;X~2=1.5,P>0.05),但均具有统计学相关性(X~2=61.09,P<0.01,0.8989;X~2=53.08,P<0.01,r=0.9245),Ⅰ型糖尿病患病年限与两法阳性检出率间具有统计学相关性(X~2=17.11,P<0.01;X~2=12.14;P<0.05),随患病年限延长而分别呈现出不同程度的下降趋势(K值)。结论:ICA和GAD抗体检测结果具有良好的一致性,可作为Ⅰ型糖尿病分型诊断较为可靠的指标,两法联合检测并结合其它血清和临床流行病学资料有助于糖尿病早期分型诊断及高危人群筛检。 Objective: To investigate and evaluate the clinical value of diag- nosis serodiagnosis. Methods: 357 diabetics clinically diagnosed were selected. Anti-islet cell antibody (ICA) antibody and glutamic acid decarboxylase (GAD) antibody were determined by fasting venous blood sampling, and other items such as blood glucose, urine glucose and glucose tolerance were measured. Results: The detection rates of ICA and GAD antibody in type Ⅰ diabetes were higher than those in type Ⅱ (X ~ 2 = 259.86, P <0.01; X ~ 2 = 288.16, P <0.01). There was no significant difference between the two methods (X ~ 2 = 2.89, P <0.05). There was no significant difference between the two methods (X ~ 2 = 0.9, P (P <0.01,0.8989); X ~ 2 = 53.08 (P <0.01, r = 0.9245); Ⅰ There was a significant correlation between the prevalence of type 2 diabetes and the positive rate of the two methods (X 2 = 17.11, P <0.01; X 2 = 12.14; P <0.05) Degree of decline (K value). Conclusion: The results of ICA and GAD antibody test have good consistency, which can be used as a reliable index for type Ⅰ diabetes mellitus. Combined with other serum and clinical epidemiological data, the two methods can be used to diagnose early stage of diabetes mellitus High-risk screening.
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先证者 ( 1 1 ) 男 ,31岁。胸闷、心悸 1月余。无剧烈胸痛。身高 175 cm,血压 135 / 80 mm Hg(1mm Hg=0 .133k Pa) ,蜘蛛指 (趾 ) ,鸡胸。掌骨指数 8.5。 X线胸片示升主动脉