老年糖尿病患者血清GAD-Ab、ICA、IAA和IA-2-Ab联合检测的临床应用价值

[目的]探讨谷氨酸脱羧酶抗体（GAD-Ab）、胰岛细胞抗体（ICA）、胰岛自身抗体（IAA）和蛋白酪氨酸磷酸酶抗体（IA-2-Ab）联合检测对老年糖尿病患者的应用价值.[方法]采用免疫印迹法检测330例老年糖尿病患者和40例正常人血清中GAD-Ab、ICA、IAA和IA-2-Ab,并对四项自身抗体全阴患者与有一项以上阳性患者的空腹血糖（FBG）、餐后两小时血糖（2hPBG）和糖化血红蛋白（HbA1c）等血液生化指标进行比较.[结果]430例老年糖尿病患者GAD-Ab、ICA、IAA和IA-2-Ab的阳性率分别为39.7%、28.5%、17.0%和16.4%,四项自身抗体全阴患者124例,占37.6%,与有一项以上阳性患者比较,其FPG、2hPBG和HbA1c水平无显著差异（P〉0.05）.[结论]四项联合检测对老年糖尿病患者的诊断及治疗方案的制定有重要意义

Clinical Value of Combined Detection of GAD-Ab, ICA, IAA and IA-2-Ab in Elderly Patients with Diabetes Mellitus

[Objective] To explore the value of combined detection of glutamic acid decarboxylase antibody（GAD-Ab）, islet cell antibody（ICA）, insulin autoantibody （IAA） and protein-tyrosine phosphatase antibody （IA-2-Ab） in elderly patients with diabetes mellitus（DM）. [Methods] Western blotting was used to detect serum GAD-Ab, ICA, IAA and IA-2-Ab in 430 elderly patients with DM and 40 healthy people. Biochemical indicators such as fasting plasma glucose（FPG）, postprandial 2h-blood glueose（PBG） and HbAlc were compared between patients with all 4 negative autoantibodies and patients with one or more positive autoantibodies. [Results]The positive rate of GAD-Ab, ICA, IAA and IA-2-Ab in 430 elderly patients with DM was 39. 7 %, 28.5%, 17.0% and 16.4%, respectively. There were 124 patients（37.6%） with all 4 negative autoantibodies. There was no difference in FPG, PBG and HbAlc between patients with all 4 negative autoantibodies and patients with one or more positive autoantibodies. [Conclusion] The combined detection of GADAb, ICA, IAA and IA-2-Ab in serum have the important significance for the diagnosis and treatment protocol of elderly patients with DM.