血清胰岛细胞抗体的测定及临床意义

作者采用Ｏ型血人新鲜胰腺冰冻切片作抗原，建立了血清胰岛细胞胞浆抗体（ＩＣＡ）的间接免疫荧光测定方法。对１５７例糖尿病患者（其中ＩＤＤＭ８２例、ＮＩＤＤＭ７５例）和８４例正常人进行了血清ＩＣＡ检测。结果，ＩＤＤＭ组、ＮＩＤＤＭ组和对照组的ＩＣＡ阳性率分别为３１．５％、１３．３％和１．１％，３组间差异有非常显著性（Ｐ＜０．００５）。ＩＤＤＭ组中，病程６个月以内者ＩＣＡ阳性率为４１．７％，病程超过６个月者为２２．６％，差异无显著性。１０例ＩＣＡ阳性的ＮＩＤＤＭ病人中，４例为口服降糖药继发失效者。提示ＩＣＡ是ＩＤＤＭ的自身免疫血清学标志，对糖尿病的病因学诊断分型及判断ＮＩＤＤＭ口服降糖药继发失效有重要意义。

SERUM CYTOPLASMIC ISLET CELL ANTIBODIES IN DIABETES MELLITUS

The authors used unfixed cryostat sections of pancreas from blood group O human as the test substrate and performed the cyto-plasmic islet cell antibody (ICA)assay by standard indirect immunofluorescence technique,ICA assay was carried out in 82 unse-lected patients with IDDM , 75 with NIDDM , and 84 normal controls.The results showed that the incidence of positive serum ICAof patients with IDDM, and NIDDM and of controls were 30.5%, 13.3%and 1.1%respectively with significant statistical differ-ence between the three groups(P<0.005).The newly diagnosed IDDM patients were found to have higher incidence of positiveserum ICA than patients who had longer than 6 months of illness(41.7%vs 22.6%, P<0.05). 4 of 10 ICA positive NLDDM pa-tients presented secondary failure to oral sulfonylurea treatment. The results indicate that 1 ) ICA prevalence is lower in Chinese pa-tients with IDDM;2)ICA is the humoral autoimmune marker of IDDM and can be used to classify the type of diabetes; and3)posi-tive ICA in NIDDM patients predicts the future development of secondary failure to oral sulfonyluria treatment.