糖尿病酮症酸中毒与氧化应激相关性分析

Correlation between oxidative stress and diabetic ketoacidosis

目的探讨急诊糖尿病酮症酸中毒与氧化应激的相关性及其意义。方法体检健康者63例（健康对照组）、糖尿病患者81例（DM组）、糖尿病酮症酸中毒患者54例（DKA组），测定总超氧化物歧化酶（T-SOD）活力、丙二醛（MDA）含量和总抗氧化力（T-AOC）。对酮症酸中毒患者的氧化应激指标与血糖和血气指标进行相关性分析。结果DM组和DKA组的T-SOD活力和T-AOC显著低于对照组（均P〈0．01），MDA含量显著高于对照组（P〈0．01）；DKA组的T-SOD活力和T-AOC显著低于DM组（均P〈0.01），MDA含量显著高于DM组（P〈0．01）。DKA组pH值、血糖与氧化应激各指标间都没有明显相关性（均P〉0．01）；阴离子间隙（AG）与T-SOD活力和T-AOC均呈显著负相关（均P〈0．01），与MDA含量呈显著正相关（P〈0．01）；HC03^-,与T-SOD活力和T-AOC均呈显著正相关（均P〈0．01），与MDA含量呈显著负相关（P〈0．01）。结论急诊糖尿病酮症酸中毒患者氧化应激与代谢性酸中毒之间具有明显相关性，氧化应激水平越高，代谢性酸中毒越严重。

Objective To explore the correlation between oxidative stress and diabetic ketoacidosis （DKA）. Methods 63 healthy persons confirmed by health checkup （healthy control group）, 82 diabetes mellitus （DM） patients （DM group）, and 54 DM patients with DKA （DKA group） underwent examination of total superoxide distamuse （T-SOD） activity, malondialdehyde （MDA） content, and total anti-oxidation capacity （T-AOC）. The anion gap （AG） was caleulated. The eorrelations were analyzed between pH, AG, HCO3^-, glucose level and oxidative stress parameters respectively. Results The T-SOD and T-AOC values of the DM and DKA groups were all significantly lower and the MDA contents of the DM and DKA groups were both significantly higher than those of the healthy control group （all P〈0.01）. The T-SOD and T-AOC levels of the DKA group were both significantly lower and the MDA content of the DKA group was significantly higher than those of the DM group （all P〈0.01）. In the DKA group, there were no significant correlations between the pH, glucose level, and the oxidative stress parameters respeetively （all P〉0.01）, there were significant negative correlations between the AG level and the T-SOD activity and T-AOC respectively （both P 〈 0.01）, there was a significant positive correlation between the AG level and MDA content （P〈 0.01）, and the HCO3^- level was significantly positively correlated with T-SOD activity and T-AOC, and negatively related with MDA content （all P〈 0.01）. Conclusion There is a significant correlation between the oxidative stress and metabolic acidosis in patients with DKA. The higher the level of oxidative stress the more severe the metabolic acidosis.