糖尿病自身抗体的检测及临床意义

目的探讨糖尿病患者血清谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA)的变化及联合检测的临床意义。方法用免疫印迹技术检测67例1型糖尿病(T1DM)患者、133例2型糖尿病(T2DM)患者血清中的GADA、ICA、IAA阳性率,并进行对比分析。结果 T1DM组中GADA、ICA、IAA的阳性率分别为66%、40%、24%,至少一种抗体呈现阳性的比例为92%,T2DM组中3种抗体的阳性率分别为9%、16%、11%,至少一种抗体呈现阳性的比例为30%。T1DM患者的GADA、ICA、IAA阳性率明显高于T2DM患者(P<0.05),三种抗体联合检测优于单一抗体。结论血清GADA、ICA和IAA的联合检测对早期、准确诊断1型糖尿病,及时规范治疗、预测B细胞功能衰竭、预测疗效及在高危人群中筛查1型糖尿病有重要临床意义。

Diabetes Autoantibody Detection and Clinical Significance

Objective To explore the clinical significance of combined detection of glutamicacid decarboxylase antibody（GADA）,islet cell antibody（ICA） and Insulin antibodies（IAA） in patients with type 2 diabetes.Methods Serum GADA,ICA and IAA were detected by ELISA in 67 of type 1 diabetes mellitus（T1DM）,133 of type 2 diabetes mellitus（T2DM） respectively,and analysed according to the positive rates of different groups.Results The positive rate of GADAwas 66%,ICA40%,IAA24% in T1DM,and that of GADAwas 9%,ICA16%,IAA11% in T2DM respectively.The positive rate of combined detection of GADA,ICA and IAA was 92% in patients with T1DM,and 30% in patients with T2DM.The positive rate of GADA,ICA,IAA in T1DM was higher than that in T2DM（P0.05）,Three kinds of antibody combined detection is superior to single antibodies.Conclusion Serum GADA,ICA and the IAA joint test for early and accurate diagnosis of type 1 diabetes,timely standardized treatment,forecasting B cell function failure,forecast and effect in high-risk groups of type 1 diabetes screening have important clinical significance.