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妊娠合并暴发性1型糖尿病并死胎2例报告 被引量：3

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摘要 暴发性1型糖尿病(FT1DM)起病急骤、病情凶险,妊娠中晚期或分娩后2周是发病的高峰,严重危及母婴生命。该文报道了2例妊娠合并FT1DM并死胎患者,既往身体健康,妊娠中晚期起病,其中1例有糖尿病家族史,1例发病前3d出现口干、多饮、多食等糖尿病症状,之后迅速出现糖尿病酮症酸中毒,另1例则无任何糖尿病症状,患者均在发现胎动减少后就诊,就诊时胎儿已死亡,起病时均有随机血糖升高,糖化血红蛋白A1c降低,空腹及餐后C-肽水平明显下降,谷氨酸脱羧酶抗体、胰岛β细胞抗体和胰岛素自身抗体均阴性,胰淀粉酶和脂肪酶正常。提示,临床医生应提高对FT1DM的警惕,尤其是妊娠妇女出现口干、多饮、多尿和发热等糖尿病症状,或胎动变化时,应予重视,及时诊治,以降低母婴病死率。
作者 胡冬梅 严晋华 杨旭斌 朱延华 张国超 曾龙驿
机构地区 广州天河区中医院内科 中山大学附属第三医院内分泌科
出处 《新医学》 2010年第3期187-188,共2页 Journal of New Medicine
关键词 暴发性1型糖尿病 妊娠 死胎 糖尿病酮症酸中毒
分类号 R714.2 [医药卫生—妇产科学] R587.1 [医药卫生—内分泌]
作者简介 通讯作者，Email：zyhywyy@yahoo．com．cn
  • 相关文献

参考文献9

  • 1IMAGAWA A, HANAFUSA T, MIYAGAWA J, et al. A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies[J]. N Engl J Med, 2000, 342 (5) : 301-307.
  • 2IMAGAWA A, HANAFUSA T, UCHIGATA Y, et al. Fulminant type 1 diabetes: a nationwide survey in Japan [ J]. Diabetes Care, 2003, 26 (8) : 2345-2352.
  • 3周健,贾伟平,包玉倩,陆蔚,陆俊茜,李青,刘芳,吴松华,项坤三.暴发性1型糖尿病合并横纹肌溶解症一例[J].中华内科杂志,2007,46(11):944-945. 被引量：26
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二级参考文献15

  • 1张弛,周智广,张冬梅,杨晓琳,周敏,林健,黄干,王建平.急骤起病伴胰酶增高的1型糖尿病临床和免疫学特征[J].中华医学杂志,2005,85(14):967-971. 被引量：46
  • 2杨晓琳,周智广.暴发性1型糖尿病[J].中国糖尿病杂志,2006,14(4):307-308. 被引量：18
  • 3周健,贾伟平,喻明,于浩泳,包玉倩,马晓静,陆蔚,胡承,项坤三.动态血糖参数正常参考值的建立及临床应用[J].中华内科杂志,2007,46(3):189-192. 被引量：79
  • 4Imagawa A,Hanafusa T,Uchigata Y,et al.Fulminant type 1 diabetes:a nationwide survey in Japan[J].Diabetes Care,2003,26(8):2345-2352.
  • 5Hanafusa T,Imagawa A.Fulminant type 1 diabetes:a novel clinical entity requiring special attention by all medical practitioners[J].Nat Clin Pract Endocrinol Metab,2007,3(1):36-45.
  • 6Nakamura T,Nagasaka S,Kusaka I,et al.HLA-DR-DQ haplotype in rapid-onset type 1 diabetes in Japanese[J].Diabetes Care,2003,26(5):1640-1641.
  • 7Shimizu I,Makino H,Imagawa A,et al.Clinical and immunogenetic characteristics of fulminant type 1 diabetes associated with pregnancy[J].J Clin Endocrinol Metab,2006,91(2):471-476.
  • 8Imagawa A, Hanafusa T, Miyagawa J, et al. A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies, Osaka IDDM Study Group. N Engl J Med, 2000, 342: 301-307.
  • 9Imagawa A, Hanafusa T, Uchigata Y, et al. Fulminant type 1 diabetes : a nationwide survey in Japan. Diabetes Care, 2003,26 : 2345-2352.
  • 10Murase Y, Imagawa A, Hanafusa T, et al. Fulminant type 1 diabetes as a high risk group for diabetic microangiopathy-a nationwide 5-year-study in Japan. Diabetologia, 2007, 50: 531- 537.

共引文献29

同被引文献43

  • 1Imagawa A, Hanafusa T, Miyagawa J, et al. A novel sub- type of type 1 diabetes mellitus characterized by a rapid onset and absence of diabetes related antibodies. N Eng J Med, 2000, 342:301-307.
  • 2Shimizu I, Makino H, Imagawa A, et al. Clinical and im-munogenetic characteristics of fulminant type I diabetes asso- ciated with pregnancy. Clin Endocr Metab, 2006, 91:471-476.
  • 3Imagawa A, Hanafusa T, Uchigate Y, et al. Fulminant type 1 diabetes: a nationwide survey in Japan. DiabetesCare, 2003, 26: 2345- 2352.
  • 4Kawasaki E, Equchi K. Genetics of fulminant type 1 diabetes. Ann N Y Acad SCI, 2006, 1079:24 - 30.
  • 5Murao S, Makino H, KainoY, et al. Dif- ferences in the contribution of HLA - DR and - DQ haplotypes to susceptibil- ity to adult - and childhood - onset type 1 diabetes in Japanese patients. Diabetes, 2004, 53: 2684-2690.
  • 6Zheng Chao, Zhou Zhiguang, Yang Lin, et al. Fulminant type 1 diabetes mellitus exhibits distinct clinical and autoim- munity features from classical type 1 diabetes mellitus in Chinese Diabetes. Metab Res Rev, 2011, 27: 70-78.
  • 7Sano H, Terasaki J, Tsutsumi C, et al. A case of fulmi- nant typel diabetes mellitus after influenza B infection. Diabetes Res ClinPract, 2008, 79: e8 - 9. Epub.
  • 8Shimizu I, Makino H, Osawa H, et al. Association of fulmi- nant type 1 diabetes with pregnancy. Diabetes Res Clin Praet, 2003, 62: 33-38.
  • 9Iwaoka T. A case of fulminant type 1 diabetes with transient- ly positive anti - GAD antibodies. Endocr J, 2003, 50: 225 -231.
  • 10Sekine N, Motokura T, Oki T, et al. Rapid loss of insulin se- cretion in a patient with fulminant typeldiabetes mellitus and carbamazepine hypersensitivity syndrome. JAMA, 2001, 285:1153 - 1154.

引证文献3

二级引证文献8

新医学
2010年 第3期

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