摘要
目的 观察不同病程I型糖尿病患者中血清胰岛细胞抗体（ICA）、谷氨酸脱羧酶抗体（GADA）和酪氨酸磷酸酶抗体（IA-2A）的阳性率，探讨胰岛自身抗体在本病发病机制和诊断中的作用。方法取41例病程≤5年和30例病程≥10年的I型糖尿病患者血清，用酶联免疫吸附法（ELISA）定性测定ICA，放射免疫一步法（RIA）定量测定GADA，免疫沉淀法（IP）定量测定IA-2A。结果ICA 、GADA 和IA-2A的阳性率分别为21.1％、39.4％和38.0％。三种抗体联合，阳性检出率为67.6％，其中GADA和/或IA-2A阳性者占62.0％。病程≤5年组GADA阳性率为51.2％，显著高于病程≥10年组（23.3％）（P< 0.01），而ICA 和IA-2A的阳性率及三种抗体的阳性种类数在两组差异均无显著性。71例患者中ICA阳性组有病毒感染史者显著高于ICA阴性组，但三种抗体均阴性者和至少一种抗体阳性者在发病年龄、体重指数、性别比例及有无糖尿病家族史、病毒感染史和其它自身免疫病等方面差异均无显著性。结论I型糖尿病患者血清胰岛自身抗体联合检测可获得较高的阳性率，对临床特点不典型患者的诊断有较大意义。GADA在短病程患者中的阳性率显著高于长病程患者，而ICA和IA-2A的阳性率与病程无关。全身性自身免疫倾向可能与胰岛自身抗体持续阳性有关，但不是其唯一原因?
Objective To test the frequency of cytoplasmic islet cell autoantibody (ICA), glutamic acid decarboxylase autoantibody (GADA), protein tyrosine phosphatase-like IA-2 autoantibody (IA-2A) or multiple autoantibodies in type I diabetes patients with different courses and to evaluate its value for pathogenesis and diagnosis of the disease. Methods Sera were obtained from 41 diabetes patients with courses within 5 years and 30 diabetes patients with courses more than 10 years. The samples were analyzed for ICA by ELISA, GADA by radioimmunoassay(RIA) and IA-2A by immune precipitation(IP) assay. Results Of all the subjects tested, 21.1％were positive for ICA,39.4％for GADA, 38.0％for IA-2A,and 67.6％for at least one of the three antibodies. In the short courses group(≤5 years), 51.2％were positive for GADA which significantly higher than that in the long courses group(≥10 years, P< 0.01), while the frequency of ICA, IA-2A, and the kinds of positive autoantibodies were not significantly different between the two groups. Virus infection history was seen more often in those with ICA positive than those ICA negative, while age of onset, body mass index, gender, family history, other autoimmune disease, and virus infection history were not significantly different between those who had no or at least one autoantibody. Conclusions Combined use of pancreatic islet autoantibodies in type I diabetes may gain a high positive rate,and it was valuable especially for the diagnosis of those who showed atypical clinical characteristics.GADA but not ICA or IA-2A was more frequent in the patients with short courses. Systemical autoimmune tendency may contribute to but not the only cause of persistent positivity of islet autoantibodies. Virus infection was seen more often in the patients with ICA positive, while age of onset and gender did not affect the positive rate of the three autoantibodies significantly.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2001年第3期273-276,共4页
Acta Academiae Medicinae Sinicae
关键词
Ⅰ型糖尿病
胰岛细胞抗体
谷氨酸脱羧酶抗体
酪氨酸磷酸酶抗体
阳性率
type I diabetes；islet cell autoantibody ；glutamic acid decarboxylase autoantibody ；protein tyrosine phosphatase-like IA-2 autoantibody ；courses of disease
