2型糖尿病酮症酸中毒与血淀粉酶的相关性研究

Correlation between Type 2 Diabetic Ketoacidosis and Blood Amylase

目的:探讨糖尿病酮症酸中毒患者与血淀粉酶的相关性。方法:共收集2016年6月-2017年12月在本院住院糖尿病患者80例作为研究对象,根据DKA的临床诊断标准将其随机分为酮症酸中毒组(DKA组)和非酮症酸中毒组(非DKA组),各40例。比较两组患者各项临床指标,DKA组患者的血淀粉酶与其他指标的相关性分析。结果:DKA组患者的年龄明显小于非DKA组,比较差异有统计学意义(t=5.653,P=0.000);两组患者糖尿病病程、BMI比较,差异均无统计学意义(t=0.026、0.154,P=0.694、0.879)。两组患者的血淀粉酶、空腹血糖、随机血糖、pH、碳酸氢根、肌酐、尿素氮临床指标比较,差异均有统计学意义(P<0.05)。在本试验中,DKA患者的年龄、尿酮体、病程、体重指数、pH、碳酸氢根、肌酐单因素与血淀粉酶无相关性(P>0.05),而随机血糖、尿素氮则与血淀粉酶有相关性(P<0.05)。DKA组血淀粉酶升高35例,所占比例为87.5%,而非DKA组血淀粉酶升高1例,所占比例2.5%,DKA组明显高于非DKA组,比较差异有统计学意义(P<0.05)。结论:DKA组的年龄较非DKA组年纪小,提示年龄较小的糖尿病患者发生DKA的可能性越大。DKA组随机血糖、空腹血糖较非DKA组偏高,提示血糖越高发生DKA的可能性越大。DKA组血pH和碳酸氢根偏低,体内酸中毒既是DKA诱因也是结果。DKA组较非DKA组血肌酐和尿素氮都升高,提示酮症酸中毒和肾功能损伤有内在联系。DKA组血淀粉酶异常率较非DKA组明显升高,说明DKA与血淀粉酶存在一定意义上的联系。

Objective：To investigate the correlation between blood amylase and diabetic ketoacidosis in patients.Method：A total of 80 diabetic patients admitted from June 2016 to December 2017 in our hospital were collected as study objects.According to the clinical diagnostic criteria of DKA,they were randomly divided into ketoacidosis group（DKA group） and non-ketoacidosis group（non-DKA group）,40 cases in each group. The clinical indexes of the two groups,and correlation analysis between serum amylase and other indexes in patients with DKA were compared.Result：The age of patients in DKA group was significantly lower than that in non-DKA group,the difference was statistically significant（t=5.653,P=0.000）.There were no significant difference between the two groups in the course of diabetes mellitus and BMI（t=0.026,0.154;P=0.694,0.879）.The clinical indexes of blood amylase,fasting blood glucose,random blood glucose,pH,bicarbonate radical,creatinine and urea nitrogen were significantly different between the two groups（P〈0.05）. In this study,age,urine ketone bodies,duration of disease,body mass index,pH,bicarbonate radical and creatinine were not correlated with blood amylase in DKA patients（P〈0.05）, but random blood glucose and urea nitrogen were correlated with blood amylase（P〈0.05）.The number of patients with elevated blood amylase were 35 cases（87.5%）,in non-DKA group was 1 case（2.5%）,the proportion of blood amylase elevation in DKA group was significantly higher than that in non-DKA group,the difference was statistically significant（P〈0.05）.Conclusion：The age of the DKA group was younger than that of the non-DKA group,suggesting that the younger the diabetic patients,the more likely they are to develop DKA.The DKA group random blood glucose,fasting blood glucose higher than the non-DKA group,suggesting that the higher the blood sugar the greater the possibility of DKA.The pH and bicarbonate of the DKA group are low,acidosis in vivo are both the cause and results of DKA.The levels of serum creatinine and urea nitrogen in the DKA group are higher than those in the non-DKA group,suggesting that ketoacidosis is associated with renal function injury.The abnormal rate of blood amylase in DKA group is significantly higher than that in non-DKA group,indicating that there is a certain relationship between DKA and blood amylase.