2型糖尿病酮症酸中毒患者血清胆红素水平临床观察

Clinical observation of serum bilirubin in diabetic ketoacidosis patients

目的观察2型糖尿病合并酮症酸中毒(DKA)患者血清胆红素水平的变化,探讨胆红素在DKA中可能的作用机制。方法回顾性收集住院的2型糖尿病(T2DM)患者73例(T2DM组),DKA患者74例(DKA组),健康对照组71例,观察血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三脂(TG)、总胆固醇(TC)、酮体、BE值。结果 T2DM组TBIL、DBIL比正常组降低(P<0.05或<0.01),TBIL与FPG、HbA1c均呈负相关(r=-0.234、-0.289,P<0.05);而DKA组TBIL、IBIL比正常组升高(P<0.01),TBIL与FPG、HbA1c、酮体均呈正相关(r=0.284、0.371、0.263,P<0.05或<0.01),与BE值呈负相关(r=-0.230,P<0.05)。结论 DKA患者血清胆红素升高可能是机体对抗氧化应激的保护性反应。

Objective To observe the change of serum bilirubin in patients with diabetic ketoacidosis and to study the mechanism of serum bilirubin in diabetic ketoacidosis.Methods 73 cases T2DM patients,74 cases patients with DKA and 71cases healthy adults subjects were retrospectively analyzed.The changes of serum bilirubin,FPG,HbA1c,TG,TC,ketobody and base excess were recorded.Results The concentrations of TBIL and DBIL in T2DM patients were lower than those in normal control group（P0.05 or P0.01）,serum TBil was negatively correlated with FPG and HbA1c（r=-0.234,r=-0.289,P0.05）;The concentrations of TBIL and IBIL in patients with DKA were higher than the normal control group（P0.01）,serum TBil was positively correlated with FPG,HbA1c and ketobody（r=0.284,r=0.371,r=0.263,P0.05 or P0.01）;In contrast,it was negatively related to BE（r=-0.230,P0.05）.Conclusion The higher lever of serum bilirubin in patients with DKA maybe a protective reaction by anti-oxidative stress.