CAJ | 학술논문

目的探讨暴发性l型糖尿病的临床特点,提高对暴发性1型糖尿病的认识,减少临床漏诊、误诊及误治.方法回顾性分析2008年1月至2011年6月空军总医院内分泌科收治的1型糖尿病患者49例,分析其发病年龄、胰岛功能、C肽水平、糖化血红蛋白、体重指数、胰岛抗体、家族史及其治疗、预后.结果 49例中经典1型糖尿病41例,成人迟发性自身免疫性糖尿病7例,暴发性1型糖尿病1例.49例中共有2例暴发性1型糖尿病.结论暴发性1型糖尿病在临床上比较少见,起病急骤,以酮症酸中毒起病,代谢严重紊乱,病死率较高,应引起临床工作者的重视.入院后纠正代谢紊乱应及时得当,酸中毒纠正后必须依赖胰岛素治疗；各项检查项目均应完善,避免漏诊、误诊及误治.
목적 탐토폭발성l형당뇨병적림상특점,제고대폭발성1형당뇨병적인식,감소림상루진、오진급오치.방법 회고성분석2008년1월지2011년6월공군총의원내분비과수치적1형당뇨병환자49례,분석기발병년령、이도공능、C태수평、당화혈홍단백、체중지수、이도항체、가족사급기치료、예후.결과 49례중경전1형당뇨병41례,성인지발성자신면역성당뇨병7례,폭발성1형당뇨병1례.49례중공유2례폭발성1형당뇨병.결론 폭발성1형당뇨병재림상상비교소견,기병급취,이동증산중독기병,대사엄중문란,병사솔교고,응인기림상공작자적중시.입원후규정대사문란응급시득당,산중독규정후필수의뢰이도소치료；각항검사항목균응완선,피면루진、오진급오치.
Objective To study the clinical characteristic of fulminant type 1 diabetes; to improve the reconstruction and to reduce the misdiagnosis and mistreatment.Methods The data of 49 hospitalization cases of type 1 diabetes mellitus from January 1,2008 to June 31,2011 in Air Force General Hospital were reviewed.Age,function of islet βcell,C-peptide level,glycosylated hemoglobin,body mass index,islet cell antibody,family history,treatment and prognosis were analyzed.Results There were 41 cases of autoimmune type 1 diabetes,7 cases was adult late onset autoimmune diabetes,there were 2 cases of fulminant type 1 diabetes.Conclusions Fulminant type 1 diabetes is relatively rare in clinical practice.The characteristics include sudden onset and ketoacidosis.The patients have severe metabolic disturbance and high fatality rate.After correcting acidosis,the patients must have insulin therapy.After admission,the patients' metabolic disorder should be corrected timely and properly.The inspection items should avoid misdiagnosis and mistreatment.