中文摘要：

目的探讨暴发性1型糖尿病（F1D）的患病状况和临床特征。方法采用Hanafusa提出的诊断标准，从中南大学湘雅二医院急性酮症起病的1型糖尿病患者中筛选F1D患者，再根据胰岛自身抗体谷氨酸脱羧酶抗体（GADA）或蛋白酪氨酸磷酸酶抗体的有无将非F1D患者分为经典1型组和特发1型组，比较3组患者临床特征的差异。结果87例急性酮症起病的1型糖尿病患者中有8例符合F1D的诊断标准，占9．1％，在18岁以上患者中占14．0％。起病时暴发组的血糖显著高于经典1型组和特发1型组（P=0．004）；暴发组血淀粉酶水平显著高于经典1型组（P=0．021）。4例（50％）患者发病初期GADA阳性，其中1例柯萨奇病毒B（CVB）IgM阳性，1例人单纯疱疹病毒1（HSV1）IgM阳性。结论FID约占以酮症或酮症酸中毒起病的1型糖尿病患者的10％。起病时F1D患者比经典1型和特发1型糖尿病患者有更严重的代谢紊乱。病毒感染和自身免疫可能参与其发病过程。

英文摘要：

Objective To investigate the prevalence and clinical features of fulminant type 1 diabetes. Methods Using data retrieved from Second Xiangya Hospital of Central South University, all patients diagnosed with type 1 diabetes from Jan. 1,2001 to Dec. 31, 2007 were identified. The patients were divided into fulminant type 1 diabetes （F1D） group, typical type 1 diabetes （T1A） group, and idiopathic type 1 diabetes（T1B） group. Their clinical features were compared. Results Eight patients （9.1%） fulfilled the criteria for fulminant type 1 diabetes among 87 newly diagnosed type 1 diabetes,and the percentage of fulminant type 1 diabetes reached 14.0% among type 1 diabetic patients with age of onset of 18 years or older. Patients of F1D group had a markedly higher plasma glucose concentration compared with patients of T1A group and T1 B group（ P = 0. 004）. Serum amylase was higher in F1D group than that in T1A group（ P= 0. 021 ）. Four （50%） patients were GADA positive,among whom 1 patient was Coxsackie B virus （CVB） IgM positive and 1 patient was Herpes Simplex virus 1 （ HSV1 ） IgM positive. Conclusions Fulminant type 1 diabetes accounts for about 10% of the type 1 diabetes in the Chinese individuals with ketosisor ketoacidosis-onset. Patients with this subset of diabetes had severe metabolic derangement. Viral infection and autoimmunity may be involved in the pathogenesis of fulminant type 1 diabetes.