糖尿病患者 GAD－Ab、IA2－Ab 和 ICA 联合检测的临床意义

摘要

目的：探讨抗谷氨酸脱羧酶抗体（GAD－Ab）、抗酪氨酸磷酸酶抗体（IA2－Ab）和抗胰岛细胞抗体（ICA）联合检测在糖尿病中的临床意义。方法选择糖尿病患者136例，其中1型糖尿病54例、2型糖尿病82例，同时选择健康对照者（正常对照组）65名，采用酶联免疫吸附试验（ELISA）检测 GAD－Ab 和 IA2－Ab，并采用间接免疫荧光法检测 ICA。结果1型糖尿病组 ICA、GAD－Ab 和 IA2－Ab 的阳性率分别为22．2％、61．1％和11．1％，明显高于2型糖尿病组（2．4％、4．9％、1．2％）及正常对照组（0％、0％、0％）（P 均＜0．05）。1型糖尿病组 GAD－Ab阳性率明显高于 ICA 和 IA2－Ab（P ＜0．001）。 GAD－Ab 诊断1型糖尿病的敏感性和诊断符合率均高于 ICA 和IA2－Ab（P ＜0．05）；GAD－Ab ＋ICA、GAD－Ab ＋IA2－Ab、ICA ＋GAD－Ab ＋IA2－Ab 联合检测的敏感性和诊断符合率亦均高于 ICA 和 IA2－Ab 单项检测（P ＜0．05）。结论 GAD－Ab、IA2－Ab 和 ICA 联合检测对糖尿病的诊断分型具有一定的意义。%Objective To investigate the clinical significance of the combined detection of anti-glutamic acid decarboxylase antibody (GAD-Ab), anti-protein tyrosine phosphatase antibody (IA2-Ab) and anti-islet cell antibody (ICA) in the diagnosis of diabetes mellitus.Methods A total of 136 patients with diabetes mellitus were enrolled, including 54 cases of type 1 diabetes mellitus and 82 cases of type 2 diabetes mellitus, and 65 healthy controls were enrolled as healthy control group.GAD-Ab and IA2-Ab were determined by enzyme-linked immunosorbent assay (ELISA), and ICA was determined by indirect immunofluorescence assay.Results The positive rates of ICA, GAD-Ab and IA2-Ab in patients with type 1 diabetes mellitus(22.2%, 61.1% and 11.1%) were significantly higher than those in patients with type 2 diabetes mellitus (2.4%, 4.9% and 1.2%) and control group (0%, 0% and 0%, P <0.05).The positive rate of GAD-Ab in patients with type 1 diabetes mellitus was higher than those of ICA and IA2-Ab(P <0.001). The sensitivity and diagnostic accordance rate of GAD-Ab were higher than those of ICA and IA2-Ab (P <0.05).The sensitivities and diagnostic accordance rates of the combined detections of GAD-Ab +ICA, GAD-Ab +IA2-Ab and ICA +GAD-Ab +IA2-Ab were also higher than those of ICA and IA2-Ab(P <0.05).Conclusions The combined detection of GAD-Ab, IA2-Ab and ICA has important significance in the diagnosis and classification of diabetes mellitus.