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酸中毒起病方式对酮症酸中毒的影响
邱俊霖,陈文,曾云先,苏会璇,何唐艳
0
(广西医科大学第九附属医院内分泌科)
摘要:
【摘要】目的 提高临床医师对酮症酸中毒起病患者酸中毒的认识。方法 选择2003年~2013年在广西医科大学附属第九人民医院北海市人民医院住院治疗的187例糖尿病酮症酸中毒患者的临床资料,根据是否酮症酸中毒起病,分为122例非酮症酸中毒起病患者和75例酮症酸中毒起病患者两组。然后将两组分为1型糖尿病组和2型糖尿病组,比较各组的年龄、血糖、血钠、血钾、糖化血红蛋白、PH值。结果 在不考虑酮症酸中毒的糖尿病分型的时候,以酮症酸中毒起病的糖尿病患者的年龄、糖化血红蛋白都低于非酮症酸中毒起病的糖尿病患者。当只将非酮症酸中毒起病的组分为1型糖尿病组和2型糖尿病组后,非酮症酸中毒起病的1型糖尿病的PH值比2型糖尿病组低。当酮症酸中毒起病组和非酮症酸中毒起病的组都分为1型糖尿病组和2型糖尿病组后,DKA起病的2型糖尿病组的血钠正常,而其他3组都具有轻度低钠。结论 临床医师应重视1型糖尿病引起的酮症酸中毒的严重性;对于酮症酸中毒起病的患者,血钠可作为初步区分2型糖尿病酮症酸中毒起病患者的指标。
关键词:  酮症酸中毒起病  糖尿病酮症酸中毒  流行病学
DOI:
基金项目:广西卫计委科研项目(82015016);北海市科学技术局基金资助项目(北科合201604003)
The influence of the diabetic ketoacidosis with onset on acidosis
QIU Junlin,CHEN Wen,ZENG Yunxian,SU Huixuan,HE Tangyan
(Department of Endocrinology & Metabolism, The Ninth Affiliated Hospital of Guangxi Medical University;Department of Electronic Information Engineering,Nanjing University of Aeronautics and Astronautics,Nanjing 210016,China)
Abstract:
【Abstract】Objective To better understand the acidosis of ketoacidosisonset patients. Methods 187 diabetic ketoacidosis patients were divided into ketoacidosisonset group (75 cases) and nonketoacidosisonset group (112 cases). Both groups were divided into type 1 diabetes group and type 2 diabetes group. The age, glucose,serum sodium,serum potassium,glycated hemoglobin and PH value were measured. Results The age and the level of glycated hemoglobin of Ketoacidosisonset group were lower than that in nonketoacidosisonset group. PH value of type 1 diabetes in nonketoacidosisonset group was lower than that of type 2 diabetes. The serum sodium of type 2 diabetes in Ketoacidosisonset group was normal, while the other three groups had mild hyponatremia. Conclusion We should pay attention to the seriousness of diabetic ketoacidosis caused by type 1 diabetes. The serum sodium can be used as the initial indicator of type 2 diabete,when face the Ketoacidosisonset patients.
Key words:  Ketoacidosis-onset  Diabetic ketoacidosis  Epidemiology

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