糖尿病三项及其临床意义（Three items of diabetes mellitus and their clinical significance）.docVIP

糖尿病三项及其临床意义（Three items of diabetes mellitus and their clinical significance） First, the method and clinical significance of insulin antibody detection 1. Biochemical characteristics and pathophysiological effects of insulin antibodies In 1983, Banting found that insulin resistant substances were present in the serum of diabetics treated with insulin, which proved to be gamma globulin, named insulin antibody. The production of insulin antibodies is related to the immunogenicity of insulin preparations, and a large number of insulin antibodies can cause the patient to be insensitive to insulin. Insulin antibody is mainly IgG, a small number of patients can be found IgM, IgD, IgE insulin antibodies, IgE antibodies mainly appear in patients allergic to insulin. Insulin antibodies in serum ranged from 95 to 99.9%, which were combined with insulin and a small number of free states. The binding rate of insulin and antibody varies depending on the concentration of insulin in the blood. The blood consists of two antibodies with high affinity low binding capacity and low affinity - high binding capacity. The affinity constant was 109 ~ 101 0mol/L, with capacity of 10 8mol/L; the affinity constant is 106 ~ 10 8mol/L, with a capacity of 10 - 7mol/L. Low affinity antibody accounted for more than 90% of the total volume, so the physiological significance is great. The physiological role for insulin and insulin antibody in blood; delayed insulin degradation, prolonged insulin release and Portland decay period; antibody to insulin; insulin transport protein; antigen antibody compound can activate complement, long-term effects can cause or aggravate microvascular disease. 2, insulin antibody detection methods and matters needing attention The main methods include immunoelectrophoresis, complement fixation, coagulation test, immunoprecipitation, gel filtration and radioimmunoassay. Because of its high sensitivity and simplicity, it is the most common method of radioimmunoassay. A un