寰浜绯灏跨锛板绉绘琛锛

澧绱楗涔锛浠ュ浠ｅ诲灞锛绯灏跨ㄥ浠宸茬涓浜虹ョ甯歌锛绯灏跨娌荤娈典ㄥ揩存般ㄥ夸娈垫堕翠互锛板绱淇杩板绱娉绯不绯灏跨╋惰锛杩浜娉涔瀛ㄧ璇稿ㄤ渚裤涓藉欢缂剧杩绋绛剧缂虹广浜浜哄戒筹㈢剁灏跨灞颁瀹绋搴ｈ板戒澶辨灏斤ｄ缁ｈЩ妞捐风Щ妞涓涓扮板锛浠ユ不绯灏跨浜瀹涓锛绉瀛浠ㄨ涓归㈠凡缁琛浜骞挎绌讹骞跺寰浜涓

绯灏跨板绉绘锛

浼ㄧワ灏界绯灏跨浠ュ涓哄澶绫诲锛浣娲讳腑涓哄父瑙渚舵2绯灏跨锛T2DM锛1绯灏跨涓瀵1绯灏跨锛T1ADM锛绉1a绯灏跨锛浣涓烘甯歌绯灏跨绫诲锛T2DMｈ浣楂琛绯浠ュ浜绉浠ｈ阿寮甯[1]锛

板绱璋韬缁缁浜х板绱垫锛充甯镐汉缁缁告锛ｈ缁缁瀵瑰锋按骞崇板绱搴涓锛锛浣胯韩浣瑕村板绱ョ淮琛绯锛

板娉板绱尾缁娉伴琛绯绱伪缁藉绱涔憋浠よ韩浣ㄩ瑕板绱朵藉拌冻澶板绱锛ㄤ瑕伴琛绯绱讹伴琛绯绱姘村钩甯镐锛

涓琛绯绁缁娉绯荤锛濡涓涓锛瀵逛汉浣涓昏ㄧㄤ--け姝ｅ父璋锛浠瀵艰磋甯搁捐¤绯拌娑蹭腑

T1ADM板跺锛郴缁涓ㄥ杩绋涓捣颁涓洪瑕浣ㄣㄧ澶уT1ADMｈ浣锛郴缁澶ч娉瀵硅板尾缁浣锛杩浜浣浼诲昏板尾缁锛褰㈡浜板朵ㄥ芥甯革浣板绱娉翠弗圭璞°浜ｈ电虫寸锛郴缁ㄩ瀵硅板尾缁讹杩浜х浜戒板绱缁板绱浣锛杩浜浣涓板绱缁寰涓㈠猴浼涓瀹跺伴惧鸿板绱锛ｈ涓ラ浣绯

浠㈢杩颁腑浠惧虹璁猴T1ADMｈ变板尾缁版ф伙ヨ藉缁ｈ绉绘涓涓芥甯哥拌烘板锛灏卞浠ュㄥ澶х搴㈠ｈ浣板绱娉T2DMｈ板尾缁借界跺锛浣板绉绘变藉ㄦ不锛姝ゆ灏辫宸澶浜

涓杩杩涔骞堕涓涓T2DM瀛ㄧ瀵宠镐技板绱垫涓绉绯灏跨--浜洪挎ц韩灏跨锛LADA锛锛变ｈ浣瀛ㄧ涓瀹姘村钩璋锋皑歌辩晶讹GAD锛浣锛涓绉界村板尾缁浣锛锛浣垮ｈ灏界涓T2DM句互哄锛浣堕存绉昏板戒杩杈T2DMｈ涓轰冲T1ADM涓蜂璧板绱[2]瀵硅绫绘ｈ瑷锛板绉绘涔娌荤规

拌/板绉绘璧锋涓板

瀵硅板/拌虹Щ妞绌跺浠ヨ拷婧1984骞达Sutherland浠浜ㄤ瀵瑰靛寮涔村濮浜澶ц灏璇锛灏朵腑ュ悍拌猴朵腑甯板锛涓灏ㄥ绉绘缁腑T1ADMｈ浠界ラ锛靛寸ㄥ绉绘锛浠ュㄤ杩琛剁典锛寰瀹规拌韬惰锛轰浜烘靛虹浜锛拌虹Щ妞绯灏跨浠浠缂瑙ｄㄤ氨澶浜锛瀵圭Щ妞拌虹妫ヨ〃拌鸿璐ｅ娉娑剁澶娉ㄥ瀹濂芥锛板尾缁借ｈ浣浣村[3]

杩涓绌剁涓鸿拌虹Щ妞绌舵臣浜涓锋按锛惰锛渚舵绉绘归㈢绉瀛缁х画瀵硅拌虹Щ妞杩琛绌躲浠浠绌跺璞″杞Щ颁ｄ涓虹灏跨寮璧风缁剧锛ESRD锛瑕杩琛绉寮浣剧Щ妞T1ADMｈ锛澶ч绌惰〃瀵硅绫绘ｈ瀹琛-捐绉绘锛绉绘杩ｈ浣拌轰涓烘ョ舵不瀛娲伙骞朵娇ｈ绯灏跨杈惧拌涔不浠浠ュ涓灏绉绘涓寮濮灏璇缁T1ADM骞舵ESRDｈ寮灞-捐绉绘锛寰浜涓缁┿杩浜骞存ワ戒灏澶у婚寮灞浜杩涓椤圭浣夸灏T1ADMｈ搴峰

惰锛杩绉褰㈠ㄨ拌虹Щ妞剧跺ㄦ剧己广朵锛变灞拌虹Щ妞婚㈠灏锛疯寰韬璧拌猴浠ュㄧЩ妞濡浣瀵圭浣ㄥ杩琛淇瀛渚挎浜澶ч朵锛变ㄨ拌虹Щ妞瑕舵不ラ插ュ搴浣娆＄村板锛舵不挎杩琛浼寮卞锛澧娣宸寸ょ轰锛涔ㄤ瀹绋搴朵ㄨ拌虹Щ妞搴ㄣ冲涓烘锛ㄨ拌虹Щ妞杩涓烘ｆESRD琛剧Щ妞ｈ涓绉┿

板绉绘

涓杩杩璇稿绌讹涔涓T1ADMｈ板绉绘甯ヤ规姝ョ绌剁锛涓绉板板绉绘规板缁绉绘杩缁ｈㄨ拌哄ㄤ绉绘板尾缁锛浠ユ瑰ｈ琛绯讹绉绘稿冲苟涔瑕灏浜缁ㄨ拌虹Щ妞杩涓规稿崇绌跺凡缁ヤ妇琛濞绯灏跨瀛璁--绗75灞缇界灏跨瀛绉瀛勾浼涓琛ㄣ

ゆ涔澶锛ㄧ浣板淇瀛归绉瀛浠寰浜宸ㄥぇ杩灞涓涓垮ぇ绉瀛㈤20骞村灏璇灏绂讳板-196′欢涓淇瀛锛骞跺20骞村В汇浠や汉版峰讳20骞寸板灞跺锋浜轰板稿缁缁缁尾缁伪缁虫涔稿斤杩浜板ㄧЩ妞ユｆT1ADM灏浣浠ヨ瑰灏琛绯姘村钩锛灏界借伴板绋宸[4]杩琛杩椤圭绌剁㈤锛ヨ板峰绘藉寰绐达浣胯板绂讳挎堕村ㄥ村锛灏辫藉ぇ澶х瑙ｈ板绉绘渚浣涓瓒崇灞充娇板绉绘涓烘不T1ADM涓昏娉

[1]Kahn SE, Cooper ME, Del Prato S. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet 2014;383:1068-1083

[2]Tuomi T, Santoro N, Caprio S, Cai M, Weng J, Groop L The many faces of diabetes: a disease with increasing heterogeneity. Lancet 2013;383:1084-1094

[3]Sibley R, Sutherland DER, Goetz F, Michael AF. Recurrent diabetes mellitus in the pancreas iso- and allograft. A light and electron microscopic and immunohistochemical analysis of four cases. Lab Invest 1985,53:132-144

[4]Fox J E M, Lyon J, Dai X Q, et al. Human islet function following 20 years of cryogenic biobanking. Diabetologia 2015: 1-10.doi: 10.1007/s00125-015-3598-4

[5]Henry M.Kronenberg , et al.Williams Textbook of Endocrinology,11E