中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
8期
580-584
,共5页
王毅%巩纯秀%曹冰燕%魏丽亚%梁学军%吴迪%刘敏%李文京%谷奕
王毅%鞏純秀%曹冰燕%魏麗亞%樑學軍%吳迪%劉敏%李文京%穀奕
왕의%공순수%조빙연%위려아%량학군%오적%류민%리문경%곡혁
暴发性1型糖尿病%经典1型糖尿病%临床特点%急性合并症
暴髮性1型糖尿病%經典1型糖尿病%臨床特點%急性閤併癥
폭발성1형당뇨병%경전1형당뇨병%림상특점%급성합병증
Fulminant type 1 diabetes mellitus%Classic type 1 diabetes mellitus%Clinical characteristic%Acute complication
目的 通过总结儿童与青少年暴发性1型糖尿病(FT1DM)和经典1型糖尿病(T1DM)发病情况及临床特点,了解两者有无区别.方法 研究2004年1月至2012年12月在首都医科大学附属北京儿童医院新诊断的T1DM患儿的特点,筛选出FT1DM作为组A,并按照起病急缓分对照组:组B为10 d内以酮症(DK)或酮症酸中毒(DKA)起病的经典T1DM,组C为30 d以内的经典T1DM,比较FT1 DM与经典T1DM的区别.结果 9年新诊断T1DM患儿853例,其中组A11例,组B 117例,组C 565例.FT1DM占所有新诊断T1DM的1.29％,占病史30 d以内的经典T1DM的1.95％.3组患儿除在发病年龄[1.33(0.95 ～9.25)岁比6.85(3.72～ 10.59)岁比7.00(4.00 ～ 10.08)岁,P=0.043]、体质量指数[16.89(15.63 ～ 19.74) kg/m2比14.49(13.46 ～ 16.19) kg/m2比14.79(13.60 ～ 16.38) kg/m2,P=0.004]、发病前流感样症状发生率(82％比47％比42％,P=0.000)、腹部症状发生率(55％比21％比16％,P=0.002)、糖化血红蛋白(HbA1c)[(7.3±1.0)％比(11.7±2.0)％比(11.8±2.3)％,P =0.000]、碳酸氢根(HCO3-)[8.20(3.10 ～ 16.85)比15.05 (10.13 ～21.10)比17.50(9.65 ～22.55),P=0.022]、天冬氨酸转氨酶[30(26～33) U/L比21(15～27) U/L比22(18～29) U/L,P=0.010]方面差异有统计学意义外,余无明显统计学及临床差异.发病前流感样症状和腹部症状常见,在急性合并症、随访胰岛素用量及血糖控制状况方面,FT1DM并未显示出与经典T1DM明显的差异.结论 儿童与青少年FT1DM发病率极低,与经典T1DM无明显区别.
目的 通過總結兒童與青少年暴髮性1型糖尿病(FT1DM)和經典1型糖尿病(T1DM)髮病情況及臨床特點,瞭解兩者有無區彆.方法 研究2004年1月至2012年12月在首都醫科大學附屬北京兒童醫院新診斷的T1DM患兒的特點,篩選齣FT1DM作為組A,併按照起病急緩分對照組:組B為10 d內以酮癥(DK)或酮癥痠中毒(DKA)起病的經典T1DM,組C為30 d以內的經典T1DM,比較FT1 DM與經典T1DM的區彆.結果 9年新診斷T1DM患兒853例,其中組A11例,組B 117例,組C 565例.FT1DM佔所有新診斷T1DM的1.29％,佔病史30 d以內的經典T1DM的1.95％.3組患兒除在髮病年齡[1.33(0.95 ～9.25)歲比6.85(3.72～ 10.59)歲比7.00(4.00 ～ 10.08)歲,P=0.043]、體質量指數[16.89(15.63 ～ 19.74) kg/m2比14.49(13.46 ～ 16.19) kg/m2比14.79(13.60 ～ 16.38) kg/m2,P=0.004]、髮病前流感樣癥狀髮生率(82％比47％比42％,P=0.000)、腹部癥狀髮生率(55％比21％比16％,P=0.002)、糖化血紅蛋白(HbA1c)[(7.3±1.0)％比(11.7±2.0)％比(11.8±2.3)％,P =0.000]、碳痠氫根(HCO3-)[8.20(3.10 ～ 16.85)比15.05 (10.13 ～21.10)比17.50(9.65 ～22.55),P=0.022]、天鼕氨痠轉氨酶[30(26～33) U/L比21(15～27) U/L比22(18～29) U/L,P=0.010]方麵差異有統計學意義外,餘無明顯統計學及臨床差異.髮病前流感樣癥狀和腹部癥狀常見,在急性閤併癥、隨訪胰島素用量及血糖控製狀況方麵,FT1DM併未顯示齣與經典T1DM明顯的差異.結論 兒童與青少年FT1DM髮病率極低,與經典T1DM無明顯區彆.
목적 통과총결인동여청소년폭발성1형당뇨병(FT1DM)화경전1형당뇨병(T1DM)발병정황급림상특점,료해량자유무구별.방법 연구2004년1월지2012년12월재수도의과대학부속북경인동의원신진단적T1DM환인적특점,사선출FT1DM작위조A,병안조기병급완분대조조:조B위10 d내이동증(DK)혹동증산중독(DKA)기병적경전T1DM,조C위30 d이내적경전T1DM,비교FT1 DM여경전T1DM적구별.결과 9년신진단T1DM환인853례,기중조A11례,조B 117례,조C 565례.FT1DM점소유신진단T1DM적1.29％,점병사30 d이내적경전T1DM적1.95％.3조환인제재발병년령[1.33(0.95 ～9.25)세비6.85(3.72～ 10.59)세비7.00(4.00 ～ 10.08)세,P=0.043]、체질량지수[16.89(15.63 ～ 19.74) kg/m2비14.49(13.46 ～ 16.19) kg/m2비14.79(13.60 ～ 16.38) kg/m2,P=0.004]、발병전류감양증상발생솔(82％비47％비42％,P=0.000)、복부증상발생솔(55％비21％비16％,P=0.002)、당화혈홍단백(HbA1c)[(7.3±1.0)％비(11.7±2.0)％비(11.8±2.3)％,P =0.000]、탄산경근(HCO3-)[8.20(3.10 ～ 16.85)비15.05 (10.13 ～21.10)비17.50(9.65 ～22.55),P=0.022]、천동안산전안매[30(26～33) U/L비21(15～27) U/L비22(18～29) U/L,P=0.010]방면차이유통계학의의외,여무명현통계학급림상차이.발병전류감양증상화복부증상상견,재급성합병증、수방이도소용량급혈당공제상황방면,FT1DM병미현시출여경전T1DM명현적차이.결론 인동여청소년FT1DM발병솔겁저,여경전T1DM무명현구별.
Objective To understand whether fulminant type 1 diabetes mellitus (FT1DM) is different from classic type 1 diabetes mellitus(T1DM) in children and adolescents by summarizing the incidence and clinical characte-ristics of the 2 types of diabetes mellitus.Methods To study the characteristics of newly diagnosed T1DM patients hospitalized at Beijing Children's Hospital,Capital Medical University from January 2004 to December 2012,cases of FT1DM were screened as group A.And according to the rapid or slow onsets,patients were divided into 2 control groups:group B had classic T1DM onset with diabetes ketosis(DK) or diabetes ketoacidosis(DKA) within 10 days,and group C had classic T1DM within 30 days,while the differences were compared between FT1DM and classic T1DM.Results Eight hundred and fifty-three cases were diagnosed as T1DM in the past 9 years,including 11 cases in group A,117 cases in group B and 565 cases in group C.FT1DM accounts for 1.29％ of all newly diagnosed T1DM and 1.95％ of classic T1DM within 30 days.In addition,onset age [1.33 (0.95-9.25) years old vs 6.85 (3.72-10.59) years old vs 7.00 (4.00-10.08) years old,P =0.043],body mass index [16.89(15.63-19.74) kg/m2 vs 14.49(13.46-16.19) kg/m2 vs 14.79(13.60 ～ 16.38) kg/m2,P =0.004],incidence of flu-like symptoms(82％ vs 47％ vs 42％,P =0.000),abdominal symptoms before onset(55％ vs 21％ vs 16％,P =0.002),glyeosylated hemoglobin(HbA1c) [(7.3 ± 1.0)％ vs (11.7 ±2.0)％ vs (11.8 ± 2.3)％,P =0.000],HCO3 [8.20(3.10-16.85) vs 15.05(10.13-21.10) vs 17.50(9.65-22.55),P =0.022],aspartate aminotransferase [30(26-33) U/L vs 21 (15-27) U/L vs 22(18-29) U/L,P =0.010] of three groups had statistical differences,while the others had no statistical or clinical differences.Flu-like symptoms and abdominal symptoms before onset were common,and in the aspects of acute complications,insulin dosage and glucose control during follow-up,FT1DM showed no obvious differences from classic T1DM.Conclusions Incidence of FT1DM in children and adolescents was very low,and no apparent differences were found between FT1DM and classic T1DM.
