高脂血症对糖尿病酮症酸中毒并发急性胰腺炎的影响

The implication of hyperlipidemia in diabetic ketoacidosis with acute pancreatitis

目的研究高脂血症与糖尿病酮症酸中毒（DKA）并发急性胰腺炎（AP）的关系。方法DKA患者75例，按是否并发AP分为病例组（DKA-AP）和对照组（DKA-NAP），观察两组禁食12h后的血糖、动脉血pH值和血清甘油三酯（TG）水平，并进行比较。结果与DKA-NAP组相比，DKA-AP组的动脉血pH值明显降低（P〈0．05）；4例DKA-AP患者的TG呈现一过性明显升高（TG≥11．3mmol／L，P〈0．05），并随着DKA的缓解而下降（TG〈5．65mmol／L）。结论高脂血症（TG≥11．3mmol／L）可能是DKA时并发急性胰腺炎的原因之一。

Objective To study the effect of hyperlipidemia in diabetic ketoacidosis（DKA） with acute pancreatitis（AP）. Methods 75 patients admitted with a diagnosis of DKA were divided into the DKA with coexisting AP（DKA-AP） group and the DKA without AP（DKA-NAP） group. Serum glucose,arterial blood gas estimation and serum triglyceride levels were collected and performed with statistical analysis. Results Compared with the DKA- NAP group,the mean pH value of DKA-AP group was lower（7.14 vs 7.29, P〈 0.05）. The marked elevation of serum triglycerides （TG ≥ 11.3mmol/L, P 〈 0.05 ） was transient in 4 DKA-AP patients and resolved （ TG 〈 5.65mmol/L） once the episode of DKA was corrected. Conclusion The pathogenesis of AP in DKA varies, but at least in some transient and profound hyperlipidemia is an identifiable factor.