暴发性Ⅰ型糖尿病2例并文献复习

Two Cases of Fulminant Type 1 Diabetes and Literature Review

目的探讨暴发性Ⅰ型糖尿病(FT1DM)的发病特点,旨在提高临床医师对FT1DM的认识及诊治水平,最终改善患者的预后。方法该文收集了该科住院的2例FT1DM患者的临床特征、化验检查、诊治经过等临床资料,复习相关文献。结果病例1以腹痛、恶心、呕吐伴胰淀粉酶升高为主。病例2在产后10 d发病,伴腹痛、恶心、呕吐及转氨酶升高为主。2例患者在发病后查血糖、血酮体明显升高,胰岛功能几乎完全衰竭,但糖化血红蛋白一般正常或轻度升高,诊断为FT1DM,经积极综合治疗后症状缓解。结论暴发性Ⅰ型糖尿病(FT1DM)常急骤起病,多于1周内迅速出现酮症酸中毒,此病病情危重,诊断不及时将危及生命。因此,早期识别,及时诊断及治疗对于疾病的预后至关重要。

Objective To explore the characteristics of fulminant type 1 diabetes(FT1DM),aiming to improve clinicians'understanding of FT1DM and the level of diagnosis and treatment,and ultimately improve the prognosis of patients.Methods This article collected the clinical characteristics,laboratory examinations,diagnosis and treatment history and other clinical data of 2 patients with FT1DM who were hospitalized in the department,and reviewed relevant literature.Results Case 1 was dominated by abdominal pain,nausea,and vomiting with elevated pancreatic amylase.Case 2 developed symptoms 10 days after delivery,with abdominal pain,nausea,vomiting and elevated transaminase.After the onset of 2 patients,blood glucose and blood ketone bodies were significantly increased,and the islet function was almost completely exhausted,but the glycosylated hemoglobin was generally normal or slightly increased.They were diagnosed with FT1DM,and their symptoms were relieved after active comprehensive treatment.Conclusion Fulminant type 1 diabetes mellitus(FT1DM)often develops abruptly and rapidly develops ketoacidosis in more than one week.This disease is critically ill and will be life-threatening if it is not diagnosed in time.Therefore,early recognition,timely diagnosis and treatment are essential for the prognosis of the disease.