NIDDM患者24小时血压监测的临床意义

用无创性动态血压监测（ＡＢＰＭ）对３０例血压正常的ＮＩＤＤＭ患者进行２４小时动态血压监测，并探讨其与自主神经病变和肾病的关系。结果：ＮＩＤＤＭ患者２４小时平均收缩压（１６．５±２．６ｋＰａ）、夜间收缩压（１６．３±３．１ｋＰａ）均较对照组（分别为１４．６±１．１ｋＰａ和１４．０±１．６ｋＰａ）明显增高；夜间收缩压负荷值增高（有１７例，占５７％）；夜间收缩压下降百分率降低（５．７％±５．０％对１０．４％±５．７％）；有神经病变的ＮＩＤＤＭ患者夜间收缩压下降百分率（３．６％±３．３％）及昼－夜尿白蛋白排泄差值（８．８％±８．５％）均低于无神经病变患者（分别为９．９％±５．１％和２０．６％±１１．１％）。提示糖尿病患者血压昼夜节律减弱或消失以及夜间血压增高可能参与糖尿病肾病的发生。

AN ELISA FOR ANTIBODIES TO GLUTAMIC ACID DECARBOXYLASE IN DIABETES MELLITUS PATIENTS

Antibodies to GAD were measured by ELISA, using recombinant GAD as antigen, in 30 healthy subjects, 30 patients with autoimmune disease, 37 IDDM and 30 NIDDM (non insulin dependent diabetes mellitus) patients. At the same time islet cell antibodies (ICA) were measured by immunofluore scence method. The incidence of GAD antibodies was 83.8% (31/37) in IDDM patients and 16.7%(5/30) in NIDDM patients, but the GAD antibodies were found in none of the patients with other autoimmune disease and in none of the healthy subjects. The results showed that the incidence of antibodies to GAD in IDDM patients was significantly higher, lasted longer and disappeared later than that of ICA (P<0.05). The antibodies to GAD will be of value in the diagnosis, treatment and elucidation of mechanism of diabetes mellitus.