以酮症起病的成年糖尿病患者自身免疫指标与尿微量白蛋白关系的探讨

目的：研究以酮症起病的成年糖尿病患者自身抗体和免疫球蛋白水平与尿微量白蛋白的关系。方法：回顾性分析42例首诊表现有酮症的成年糖尿患者（K组）和30例新发无酮症倾向的2型糖尿病患者（c组）尿微量白蛋白、谷氨酸脱羧酶抗体（GADAb）、胰岛细胞抗体（ICA）、免疫球蛋白（IgA、IgG、IgM）等指标。以GADAb和／或ICA阳性与否再分为胰岛自身抗体阳性组（A组）和抗体阴性组（B组），对比上述指标。结果：K组尿微量白蛋白阳性率（24h尿微量白蛋白〉30mg为阳性）、GADAb和／或ICA阳性率和IgG水平高于C组；A组尿微量白蛋白阳性率、IgG水平高于B组。结论：以酮症起病的成年糖尿病患者尿微量白蛋白升高与自身免疫异常相关（R=0．621）。

Relationship Between Sermn Autoimmune Antibodies and Trace Urinary AIbmnin in New-onset Adult Diabetic Patients With Unprovoked Ketosis

Objective： To study the relationship between the serum autoimmune antibodies and trace urinary albumin in new-onset adult diabetic patients with unprovoked ketosis. Methods： Trace urinary albumin, serum glu- tamic acid decarboxYlase antibody （GADAb）, serum Islet cell antibody （ICA） and immunoglobulins（IgA. IgG. IgM） were observed in 42 new-onset adult diabetic patients with unprovoked ketosis （K group） and 30 new-onset type 2 diabetes patients without ketotic tendency （C group） retrospectively. All the K group patients were divided into au- toimmune antibody positive group （A group） and negative group （B group） based on the presence or absence of cell autoantibodies （GADAb and ICA）. Results： Level of IgG, positive ratio of trace urinary albumin and GADAb/ICA in K group were significantly higher than those of C group. Positive ratio of trace urinary albumin and serum IgG in A group were significantly higher than those in B group. Conclusion： Trace urinary albumin is related to the immu- nologic abnormality in patients with new-onset adult diabetic patients with unprovoked ketosis（R = 0. 621）.