酒精性慢性胰腺炎继发糖尿病的临床特点分析

目的：探讨酒精性慢性胰腺炎继发的糖尿病与成年隐匿性自身免疫糖尿病（ LADA）及2型糖尿病（T2DM）患者的临床资料、代谢指标及生化检查的差异。方法对2005~2014年于本院内分泌和消化科住院治疗的符合WHO糖尿病诊断标准的酒精性慢性胰腺炎继发的糖尿病患者24例,LADA患者30例及T2DM患者40例的病史,临床资料进行回顾性分析和比较。结果酒精性慢性胰腺炎继发糖尿病患者的体重指数（BMI）与LADA患者的差异无显著性,明显低于T2DM患者。酒精性慢性胰腺炎继发糖尿病的空腹C肽值要高于LADA组患者,低于T2DM患者,总胆固醇（ CHO）和低密度脂蛋白胆固醇（ LDL-C）水平低于LADA及T2DM患者,外周血管病变的发生低于T2DM患者。结论长期大量饮酒患者出现糖尿病,应注意鉴别有无酒精性慢性胰腺炎继发的糖尿病,该类患者体型偏瘦,CHO及LDL-C低于LADA及T2DM患者,易出现低血糖,但是无酮症倾向。

The Analysis of the Clinical Characteristics of the Secondary Diabetes of Alcoholic Chronic Pancreatitis

Objective To investigate the secondary diabetes of alcoholic chronic pancreatitis and latent autoimmune diabetes in adults （LADA） and type 2 diabetes（T2DM） in patients with clinical data, metabolism and biochemical examination. Method 24 cases with the secondary diabetes of alcoholic chronic pancreatitis, 30 patients with LADA, 40 patients with T2DM were chosen in this study. All the patients were confirmed to the WHO′s standard of diagnosis of diabetes mellitus. A retrospective analysis was done about the clinical data and laboratory examination of the 94 cases. Result there were no significant differences in body mass index in patients with LADA and the patients with the secondary diabetes of alcoholic chronic pancreatitis, was significantly lower than that in patients with T2DM. Fasting C peptide of the patients with the secondary diabetes of alcoholic chronic pancreatitis was higher than that of patients with LADA, lower than that in patients with T2DM. Total cholesterol and low density lipopro-tein cholesterol levels of the patients with the secondary diabetes of alcoholic chronic pancreatitis were lower than the patients with LADA and the patients with T2DM. The peripheral vascular diseases in patients with the secondary diabetes of alcoholic chronic pancreatitis are less than in patients with T2DM. Conclusion If the patients with dia-betes have long term drinking, we should distinguish whether they have the secondary diabetes of alcoholic chronic pancreatitis. These patients characterized by low body mass, low levels of total cholesterol and low density lipopro-tein cholesterol. This type diabetic patients are prone to hypoglycemia, but not ketosis.