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目的观察使用外源性胰岛素治疗的T2DM患者血清胰岛素/C-P比值与胰岛素抗体(IA)之间的关系。方法对2009年至2013年283例检测过IA并使用外源性胰岛素及胰岛素类似物治疗的T2DM患者进行回顾性研究,按照IA测定结果将其分为IA阳性组及IA阴性组,采用受试者工作特征(ROC)曲线评价血清胰岛素及C-P与IA阳性的关系,寻找最佳预测切点。结果 IA阳性组FIns和2 hIns与C-P比值高于IA阴性组(P<0.0001)。FIns、2 hIns、FIns/FC-P比值、2 hIns/2 hC-P比值可分别用来预测IA(P<0.0001),其中FIns/FC-P预测效果最好,达到0.881。当FIns/FC-P为8.6时,预测IA的敏感性为80%,特异性为83%。结论 IA阳性组的血清胰岛素监测值升高,血清胰岛素升高与C-P变化不成比例。使用外源性胰岛素的T2DM患者,当FIns/FC-P比值>8.6或2 hIns/2 hC-P比值>17.8时,说明体内可能存在IA,比值越高,可能性越大。
Objective To investigate the relationship between serum insulin / C-P ratio and insulin antibody (IA) in T2DM patients treated with exogenous insulin. Methods A retrospective study was performed on 283 T2DM patients who had been treated with exogenous insulin and insulin analogues from 2009 to 2013. According to the results of IA, they were divided into IA-positive group and IA-negative group. (ROC) curve to evaluate the relationship between serum insulin, CP and IA, and find out the best cutoff point. Results The ratio of FIns and 2 hIns to C-P in IA-positive group was higher than that in IA-negative group (P <0.0001). FIns, 2hIns, FIns / FC-P ratio and 2hIns / 2hC-P ratio could be used to predict IA (P <0.0001). FIns / FC-P had the best predictive value of 0.881. When FIns / FC-P was 8.6, the sensitivity of IA was predicted to be 80% with a specificity of 83%. Conclusion Serum insulin monitoring value increased in IA positive group, and serum insulin level increased disproportionately with C-P change. In T2DM patients with exogenous insulin, there is a potential for IA in vivo when FIns / FC-P ratio> 8.6 or 2 hIns / 2 hC-P ratio> 17.8, and the greater the odds, the greater the likelihood.