妊娠期糖尿病患者三种血清自身抗体联合检测及其临床意义

目的 联合检测谷氨酸脱羧酶抗体（GADA）、胰岛细胞抗体（ICA）、胰岛素自身抗体（IAA）等自身抗体在妊娠期糖尿病（GDM）患者中的表达,并评价其与临床预后的相关性。方法采用间接酶联免疫吸附法检测GADA、ICA和IAA。结果GDM组的血清GADA、ICA和IAA阳性率分别为12．5％、6．25％及2％,其阳性率均较低,与正常对照组比较差异无统计学意义（P〉0．05）;自身抗体阳性组在妊娠结局、新生儿体重及胰岛素治疗与自身抗体阴性组比较差异有统计学意义（P〈0．05）。结论自身抗体阳性的GDM患者易发生妊娠失败及新生儿体重异常,产后发展为1型糖尿病（T1DM）的风险大大增加,尤其是需胰岛素治疗者。尽早发现自身抗体阳性等高危因素,可以指导临床诊断与治疗,减少母体及子代并发症的发生,改善妊娠结局及疾病转归。

Combined determination of three autoantibodies in gestational diabetic patients and its clinical significance

Objective To evaluate the significance and relationship with clinical prognosis of combined determination of glutamic acid deearboxylase antibody （ GADA）, islet cell antibody （ICA） and insulin auto - antibodies （IAA） in gestational patients with diabetes mellitus （GDM）. Methods GADA, ICA and IAA were detected by indirect enzyme - linked immunosorbent assay. Results The positive rate of GADA, ICA and IAA in GDM group were 12.5%, 6. 25% and 2%, and there was no significant difference compared with the normal control group （P 〉 0.05）. However, autoantibody positive group were significantly different in pregnancy outcome, birth weight and insulin treatment compared with the autoantibodynegative group （P 〈 0.05）. Conclusion Autoantibody - positive patients with GDM prone to pathological pregnancy and abnormal birth weight. The risk of postnatal development of type 1 diabetes mellitus （T1DM） was significantly increased, especially those who need insulin therapy. Early detecting autoantibodies can guide the clinical diagnosis and treatment to reduce the maternal and offspring complications and improve pregnancy outcome and disease prognosis.