磺脲类药物继发性失效患者GAD-Ab、ICA的测定

Messured of GAD-Ab and ICA in patients with secondary failure of sulfonylurea

目的 :探讨磺脲类药物继发性失效 ( SFS)的发病原因。方法 :对 48例 SFS患者初诊时空腹血糖 ( FPG)、C-肽 ( FC- P)进行回顾 ,并对入选 SFS后的患者测定了谷氨酸脱羧酶抗体 ( GAD-Ab)、胰岛细胞抗体 ( ICA)。结果 :48例 SFS患者 GAD- AB阳性者 9例 (占 1 8.75% ) ,ICA阳性者 6例 (占 1 2 .50 % ) ,6例 ICA阳性者其 GAD- Ab均为阳性。 48例 SFS患者初诊时 FPG≥ 1 2 mmol/L占 90 %以上 ,FC- P≤ 0 .8μg/L占 80 %以上。 48例 SFS患者符合成人迟发型自身免疫性糖尿病( LADA) 6例 (占 1 2 .5% )。结论 :非肥胖 2型糖尿病 ( DM)患者发病初期 FPG≥ 1 2 mmol/L、FC- P≤0 .8μg/L者 ,易导致 SFS,SFS患者中有一部分是 LADA。

Objective:To invesigate the pathogenesis in noninsulin dependent diabetes mellitus patients with secondary failure of sulfonylurea(SFS).Methods:The fasting C peptide(FC P)and fasting plasma glucose(FPG)were reviewed in 48 SFS patients at first consultation.The antibodies of glutamic acid decarboxylase(GAD Ab),pancreatic cell antibodies(ICA) in patients with SFS were measured.Results:Of 48 patients,nine (18.75%)were positive for GAD Ab,six (12.5%)were both positive for ICA and GAD Ab:at first consultation,FPG≥12mmol/L was beyond 90% and FC P≤0.8 μg/L was beyond 80%.The patients with SFS who conformed to LADA was six(12.5%).Conclusion:It shows that SFS was easy brought about in the patients with non fat 2 type DM at the beginning of disease who FPG≥12mmol/L and FC P≤0.8μg/L and some patients with SFS were LADA.