酮症倾向2型糖尿病23例临床特征分析

THE CLINICAL CHARACTERISTICS OF 23 CASES OF PATIENTS WITH KETOSIS-PRONE TYPE Ⅱ DIABETES

目的探讨酮症倾向2型糖尿病患者临床特征。方法对80例25～45岁糖尿病患者行谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA)、胰岛素抗体(IAA)检测,根据抗体的阳性和阴性、胰岛β细胞的功能差异、尿酮阴性和阳性将其分为1型糖尿病组、2型糖尿病酮症组和2型糖尿病非酮症组。将2型糖尿病酮症组与1型糖尿病组、2型糖尿病非酮症组在临床特征和实验指标方面进行比较总结。结果与2型糖尿病非酮症组比较,2型糖尿病酮症组的患者发病年龄小、病程短、胰岛功能差。与1型糖尿病组比较,胰岛β细胞功能相对较好,有明显的家族遗传倾向。结论自发酮症倾向的2型糖尿病患者可能具有不同的临床异质性。

Objective To investigate the clinical characteristics of ketosis - prone type Ⅱdiabetes. Methods Glutamic acid decarboxlyse antibodies （ GADA）, islet cell antibodies （ ICA ）, insulin antibodies （ IAA ） were measured in 80 cases. The patients were divided into type Ⅰ diabetes group ; ketosis - prone type Ⅱ diabetes group and without ketosis type Ⅱ diabetes group according to state of illness, positive or negative of antibodies and ketonuria. The clinical characteristic and laboratory finding of type Ⅱ diabetes with ketosis - prone were compared with type Ⅱ diabetes without ketosis and type Ⅰ diabetes. Results Compared with type Ⅱ diabetes without ketosis, the patients of type Ⅱdiabetes with ketosis - prone has lower ages, shorter course of disease and worse β cell function. When compared with type Ⅰ diabetes, it had better β cell function , obvious heredity prone, higher blood pressure, more proportion of fatty liver, obesity and metabolism syndrome. Conclusion there may be a clinical heterogeneity in ketosis- prone type Ⅱ diabetes.