糖尿病酮症酸中毒起病的暴发性1型糖尿病的实验室指标研究

The laboratory data of the ketoacidosis-onset of fulminant type 1 diabetes patients

目的：提高临床医师对糖尿病酮症酸中毒（DKA）起病的暴发性1型糖尿病（FT1DM）的认识。方法：采用2012年Imagawa提出的标准诊断,回顾我院2003~2013年本院住院的DKA患者情况,选择7例DKA起病的FT1DM患者。结合国内报道的18例患者的实验室数据进行分析。结果：25例DKA起病的FT1DM患者中,男10例,女15例;南方19例,北方6例;妊娠相关患者8例;≤30岁11例,〉30岁14例。将男性和女性、南方和北方、妊娠相关和非妊娠相关、≤30岁和〉30岁患者的糖化血红蛋白、血糖、血钠、血钾、血pH值进行比较,差异均无统计学意义。结论：DKA起病的FT1DM患者的糖化血红蛋白〈8.7%的同时,呈现高血糖、低血钠、高血钾、低pH值,应引起重视。

Objective：To better understand the acidosis of ketoacidosis-onset fulminant type 1diabetes patients.Method：With the diagnostic criteria proposed by Imagawa（2012）,6cases of ketoacidosis-onset FT1 DM patients were screened from the admitted diabetic ketoacidosis patients in the Ninth Affiliated Hospital of Guangxi Medical University from 2003 to 2013.Combined with 18 cases of ketoacidosis-onset FT1 DM had been reported in our Country,their laboratory datas were analyzed.Result：There were no significant differences regarding the laboratory data（glucose,serum sodium,serum potassium,glycated hemoglobin and pH value）between the two groups（male vs female,south vs north,pregnancy-associated vs not associated with pregnancy,≤30years old vs 〉30years old）.Conclusion：Our study indicates the ketoacidosis-onset fulminant type 1diabetes patients whose glycated hemoglobin are normal or less than 8.7%should be given more attention as they shared low level of pH,serum sodium and high level of serum glucose,serum potassium.