Hulinský I, Dryáková M, Kaslík J, Malý J
Institut klinické a experimentálni medicíny, Praha.
Vnitr Lek. 1990 Feb;36(2):147-53.
The authors examined 21 patients with type I diabetes within 30 days after establishment of the diagnosis and during the first year of the disease. In 17 they detected autoantibodies against insulin at the time of assessment of the diagnosis before administration of the therapeutic insulin preparation. Fourteen patients had antibodies against the surface of islet cells (ICSA), the titre of which declined during the first year of the disease. The serum immunoglobulin level (IgG, IgM and IgA) was on average within the normal range; however, in two patients at the time of establishment of the diagnosis and in three patients after one month IgG was above normal, in eight patients the IgM level was at the time of establishment of the diagnosis above normal, one month later this was the case only in two patients and in four patients the IgA level was permanently low. During the investigation period the level of C-3 and C-4 components of the complement declined steadily and the level of circulating immune complexes increased. The mentioned deviations were not associated with the concurrent infectious disease at the time of establishment of the diagnosis or with metabolic indicators. The patients were treated the whole time by an intensified insulin regime--principle basal bolus or continuous subcutaneous infusion of single component insulin.
作者在确诊后30天内及疾病的第一年对21例I型糖尿病患者进行了检查。在17例患者中，在给予治疗性胰岛素制剂之前评估诊断时检测到抗胰岛素自身抗体。14例患者有抗胰岛细胞表面抗体（ICSA），其滴度在疾病的第一年有所下降。血清免疫球蛋白水平（IgG、IgM和IgA）平均在正常范围内；然而，在确诊时2例患者以及1个月后3例患者的IgG高于正常，8例患者在确诊时IgM水平高于正常，1个月后仅2例患者如此，4例患者的IgA水平持续偏低。在调查期间，补体的C-3和C-4成分水平稳步下降，循环免疫复合物水平升高。上述偏差与确诊时并发的传染病或代谢指标无关。患者始终采用强化胰岛素治疗方案——基础大剂量原则或单组分胰岛素持续皮下输注。
