中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2014年
10期
721-724
,共4页
王毅%巩纯秀%曹冰燕%魏丽亚
王毅%鞏純秀%曹冰燕%魏麗亞
왕의%공순수%조빙연%위려아
糖尿病,1型%青少年%暴发性
糖尿病,1型%青少年%暴髮性
당뇨병,1형%청소년%폭발성
Diabetes mellitus,type 1%Adolescent%Fulminant
目的 调查暴发性1型糖尿病(FT1D)的发病情况及临床特点,明确该亚型在儿童及青少年中分型的临床意义.方法 调查2004年1月至2012年12月我院新确诊的18岁以下1型糖尿病(T1D)患者,共853例,根据FT1D的诊断标准共筛出11例FT1D.依照相同性别、相近年龄(±2岁)、相同季节、相同年份在我院糖尿病病例库中按1:4的比例进行匹配,选取经典型T1D44例.总结两组的临床特点、实验室检查,随访至少1年的临床结局.结果 853例中,以酮症(DK)或酮症酸中毒(DKA)急性起病的经典1型者468例,符合FT1D诊断标准的患者11例(男孩6例),暴发性占所有T1D的1.29%,占DK或DKA急性起病的T1D的2.35%.暴发组与经典组相比,除体质指数(BMI)差异有统计学意义外,在急重症并发症发生率、治疗后蜜月期发生率及持续时间、电解质紊乱程度等方面差异均无统计学意义.结论 18岁以下患者FT1D发生比例极低,与经典T1D相比,未显示出明显差异.但由于病例较少,需要积累数据进一步探究该亚型分型的临床意义.
目的 調查暴髮性1型糖尿病(FT1D)的髮病情況及臨床特點,明確該亞型在兒童及青少年中分型的臨床意義.方法 調查2004年1月至2012年12月我院新確診的18歲以下1型糖尿病(T1D)患者,共853例,根據FT1D的診斷標準共篩齣11例FT1D.依照相同性彆、相近年齡(±2歲)、相同季節、相同年份在我院糖尿病病例庫中按1:4的比例進行匹配,選取經典型T1D44例.總結兩組的臨床特點、實驗室檢查,隨訪至少1年的臨床結跼.結果 853例中,以酮癥(DK)或酮癥痠中毒(DKA)急性起病的經典1型者468例,符閤FT1D診斷標準的患者11例(男孩6例),暴髮性佔所有T1D的1.29%,佔DK或DKA急性起病的T1D的2.35%.暴髮組與經典組相比,除體質指數(BMI)差異有統計學意義外,在急重癥併髮癥髮生率、治療後蜜月期髮生率及持續時間、電解質紊亂程度等方麵差異均無統計學意義.結論 18歲以下患者FT1D髮生比例極低,與經典T1D相比,未顯示齣明顯差異.但由于病例較少,需要積纍數據進一步探究該亞型分型的臨床意義.
목적 조사폭발성1형당뇨병(FT1D)적발병정황급림상특점,명학해아형재인동급청소년중분형적림상의의.방법 조사2004년1월지2012년12월아원신학진적18세이하1형당뇨병(T1D)환자,공853례,근거FT1D적진단표준공사출11례FT1D.의조상동성별、상근년령(±2세)、상동계절、상동년빈재아원당뇨병병례고중안1:4적비례진행필배,선취경전형T1D44례.총결량조적림상특점、실험실검사,수방지소1년적림상결국.결과 853례중,이동증(DK)혹동증산중독(DKA)급성기병적경전1형자468례,부합FT1D진단표준적환자11례(남해6례),폭발성점소유T1D적1.29%,점DK혹DKA급성기병적T1D적2.35%.폭발조여경전조상비,제체질지수(BMI)차이유통계학의의외,재급중증병발증발생솔、치료후밀월기발생솔급지속시간、전해질문란정도등방면차이균무통계학의의.결론 18세이하환자FT1D발생비례겁저,여경전T1D상비,미현시출명현차이.단유우병례교소,수요적루수거진일보탐구해아형분형적림상의의.
Objective To investigate the frequency and clinical characteristics of fulminant type 1 diabetes (FT1 D) and to clarify the clinical significance of the subtype in pediatrics.Methods Case-control study designed and Data collected from hospitalized registration system.All new diagnosed type 1 diabetes (T1 D) patients from January 2004 to December 2012 were enrolled.According to the diagnostic criteria,we obtained 11 FT1D cases from 853 T1D,at the same time,we match the classical type as control group according to the same gender,age(± 2 years),the same season and same year with a ratio of 1:4.We studied the clinical features,laboratory parameters and follow-up clinical outcome for at least one year in both groups.Results There were 468 classical type 1 diabetes patients onset with diabetic ketosis(DK) or diabetic ketoacidosis(DKA) among 853 cases.Eleven cases (6 boys) were in line with FT1D criteria.Frequency of FT1D accounted for 1.29% of all classic T1D,and 2.35% in T1D with DK or DKA onset.Compared with the classical group,fluminant group has no statistical significance in acute severe complications,the honeymoon rate and lasting period,abnormal electrolytes and etc,except body mass index (BMI).Conclusions Frequency of FT1D below 18 years old is very low,ruminant group shows no obvious differences compared to the classical group.However,so rare FT1D cases,we must do further study in the future to explore the clinical significance of this subgroup in pediatrics.