糖尿病酮症酸中毒患者血pH值、血糖水平与心肌酶、淀粉酶的相关性分析

Correlation analysis of blood pH,blood glucose level,myocardial enzymes and amylase in patients with diabetic ketoacidosis

目的分析糖尿病酮症酸中毒患者血pH值、血糖水平与心肌酶、淀粉酶的相关性,为糖尿病酮症酸中毒患者的临床诊治提供参考。方法回顾性分析2016年2月—2017年9月陆军军医大学第一附属医院内分泌科收治糖尿病酮症酸中毒患者135例的临床资料,根据其病情严重程度分为轻、中、重度3组,各45例。观察3组患者的血pH值、血糖、血淀粉酶、血脂以及心肌酶谱的变化,并分析患者血pH值、血糖水平与心肌酶、淀粉酶的相关性。结果随着糖尿病酮症酸中毒患者病情的加重,其血pH值逐渐降低,血糖水平逐渐升高;血清肌酸激酶(CPK)、肌酸激酶同工酶(CPK-MB)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)以及三酰甘油(TG)、血淀粉酶水平逐渐升高,总胆固醇(TC)水平逐渐降低,3组之间比较差异均有统计学意义(P<0.05)。患者血pH值与TC、AST以及LDH水平呈现正相关(r=0.418、0.432、0.454,P均<0.05),与TG水平呈现负相关(r=-0.425,P=0.013);血糖水平与TC、AST以及LDH水平呈现负相关(r=-0.405、0.418、0.436,P均<0.05),与TG水平呈现正相关(r=0.432,P=0.012)。结论糖尿病酮症酸中毒患者血pH值与患者的血淀粉酶、LDH以及AST水平呈现负相关,血糖水平与血淀粉酶、LDH以及AST水平呈现正相关。

Objective To investigate the relationship between blood pH, blood glucose, myocardial enzymes and amylase in patients with diabetic ketoacidosis, and to provide a reference for the clinical diagnosis and treatment of diabetic ketoacidosis patients. Methods The clinical data of 135 diabetic patients with diabetic ketoacidosis admitted from February 2016 to September 2017 in our hospital were retrospectively analyzed. According to their severity, the patients were divided into mild, moderate and severe groups with 45 cases in each group. The changes of blood pH and blood glucose level were observed in three groups of patients. The changes of blood amylase,lipids and myocardial enzymes were compared among the three groups. Spearman correlation analysis was used to analyze the correlation between blood pH, blood glucose, myocardial enzymes and amylase. Results With diabetic ketoacidosis patients’ condition aggravate, their blood pH value gradually decreased,blood glucose levels gradually increased; The levels of TG, serum amylase, CPK and AST in severe group and moderate group were significantly higher than those in mild group （severe group t =5.419, P 〈0.01, t =4.089, P 〈0.01, t = 11.285 , P 〈0.01, t =3.181, P 〈0.001; moderate group： t =2.441, P 〈0.008, t =2.273, P 〈0.013, t =7.644, P 〈 0.01 , t =2.325, P 〈0.011）, TC levels were significantly lower than those in the mild group （severe group： t =3.635, P 〈0.000; moderate group： t =1.758, P 〈0.041）; serum TG, CPK, CPK-MB, LDH, AST and serum amylase gradually increased high, TC level gradually decreased. There was a positive correlation between blood pH and TC,AST and LDH （ r = 0.418, P = 0.018; r = 0.432, P = 0.012; r = 0.454, P = 0.002, r = -0.425, P = 0.013）. There was a negative correlation between blood glucose and TC,AST and LDH （ r = -0.405, P = 0.028; r = 0.418, P = 0.010）. There was a positive correlation with TG level （ r = 0.436, P = 0.012）. There was no correlation between pH value and blood glucose levelwith CPK-MB and CPK.The blood pH value of patients with diabetic ketoacidosis is negatively correlated with the level of serum amylase,LDH and AST,and there is a positive correlation between the blood glucose level and the level of serum amylase,LDH and AST in patients with diabetic ketoacidosis.