7例暴发性1型糖尿病与非急骤起病1型糖尿病的临床特征比较

目的比较分析暴发性1型糖尿病与非急骤起病1型糖尿病临床特征的不同点。方法回顾性比较分析7例暴发性1型糖尿病（F组）与40例非急骤起病1型糖尿病患者NF组，其中经典1型患者（A组）28例，成人晚发型患者（B组）12例]的一般资料、血糖、血清淀粉酶、血气分析、血电解质指标、C肽水平、胰岛细胞抗体、谷氨酸脱羧酶抗体和胰岛素自身抗体等临床特征的差异。结果F组患者高血糖症状持续时间较NF组明显缩短，存在前驱感染的例数明显多于NF组者，血电解质和酸碱紊乱程度明显重于NF组（均P〈0．05或0.01）；F组患者糖化血红蛋白水平较A组和B组患者明显降低（P〈0．01）；F组患者入院时血肌酐水平较A组患者明显增高（P〈0.05）。结论暴发性1型糖尿病患者的代谢紊乱程度较非急骤起病的1型糖尿病者更严重。

Compare of the clinical characteristics between fulminant type 1 diabetes and nonfulminant type 1 diabetes

Objective To investigate the different clinical characteristics between fulminant type 1 diabetes and nonfulminant type 1 diabetes. Methods Clinical data of 47 cases of type 1diabetes diagnosed from January 2000 to January 2009 were retrospectively reviewed. Seven cases fell into the criteria of fulminant type 1 diabetes （group F, n= 7）, and the remaining 40 cases included 28 patients with acute onset （group A） and 12 with slow onset （group S）. The clinical characteristics were compared among three groups. Results Compare to nonfulminat group patients in group F appeared shorter duration of symptoms （4d vs 694d, P 〈 0.01）, higher blood glucose, lower HCO3^- （5.3 mmol/L vs 15.6 mmol/L, P 〈 0.01） and BE（-21.9 mmol/L vs -10.24mmol/L, P 〈 0.05）, higher serum potassium （4.82 mmol/L vs 4.10 mmol/L, P 〈 0.001）, and lower HbAlc （6.5% vs. 12.9%, P〈0.001）. Conclusion Fulminant type 1diabetes showed severer metabolic derangements than nonfulminant diabetes.