糖尿病检测谷氨酸脱羧酶抗体、胰岛细胞抗体和胰岛素自身抗体的临床意义

Clinical Significance of Detection of GAD-Ab,ICA and IAA in Patients with Diabetes Mellitus

探讨血清谷氨酸脱羧酶抗体(GAD-Ab)、胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA)检测对糖尿病(DM)的临床意义。对46例1型糖尿病(DM1)、78例2型糖尿病(DM2)和50名对照组应用增敏化学发光免疫分析法、RIA法检测其血清中GAD-Ab、ICA和IAA的阳性率并进行分组分析。结果表明DM1组GAD-Ab、ICA和IAA阳性率分别为67.39%、39.13%和23.91%,三者联合检测阳性率为91.30%,均显著高于DM2组(P<0.01)及对照组(P<0.01);DM2组GAD-Ab、ICA和IAA阳性率分别为8.97%、15.39%和10.26%,三者联合检测的阳性率为29.49%,也显著高于对照组(P<0.01)。结论是血清GAD-Ab、ICA和IAA的检测对DM的分型、指导临床用药以及判断预后具有重要的临床应用价值。

To explore value of combined detection of glutamic acid decarboxylase antibody（GAD- Ab）, islet cell antibody（ICA） and insulin autoantibody（IAA） in patients with diabetes mellitus （DM）. Serum GAD-Ab, ICA and IAA were detected by chemiluminescent immunoassay and RIA in 46 of type 1 diabetes mellitus （1 DM）, 78 of 2 DM respectively, and in 50 nondiabetic subjects as control group, and analysed according to the positive rates of different groups. Results showed that the positive rate of GAD-Ab was 67. 39%, ICA 39. 73%, IAA 23. 91% in 1 DM,and that of GAD-Ab was 8.97%,ICA 15.39%,IAA 10.26% in 2 DM respectively. The positive rate of combined detection of GAD-Ab, ICA and IAA was 91. 30% in patients with 1 DM, and 29.49% which was higher than that in control group （P〈0.01）. The detection of serum GAD-Ab,ICA and IAA might be regarded as clinical significance for classification, treatment and predict prognosis of DM.