血酮测定评估急性胃肠炎患儿脱水和代谢性酸中毒的价值

Value of blood ketone in determination and evaluation of dehydration and metabolic acidosis in children patients with acute gastroenteritis

目的探讨血酮测定在评估急性胃肠炎患儿脱水和代谢性酸中毒中的价值。方法选医院治疗的急性胃肠炎脱水患儿156例,在首次给药前检测其血酮和血清碳酸氢盐浓度。根据脱水评分对患儿脱水程度进行分级,根据血清碳酸氢盐浓度对代谢性酸中毒程度进行分级。对不同脱水程度、不同酸中毒程度患儿血酮浓度进行对比,并对血酮浓度与脱水评分和血清碳酸氢盐浓度进行相关性分析。结果随脱水程度增加,患儿血酮值明显升高(P <0.05);随代谢性酸中毒程度增加,血酮值也明显升高(P <0.05)。血酮浓度与脱水评分呈正相关(r=0.878,P=0.000),而与血清碳酸氢盐浓度呈负相关(r=-0.605,P=0.000)。结论急性胃肠炎脱水患儿的血酮值与脱水评分呈正相关,与血清碳酸氢盐浓度呈负相关;血酮监测可用于初步评估急性胃肠炎患儿的脱水和代谢性酸中毒情况。

Objective To explore the value of blood ketone in the determination and evaluation of dehydration and metabolic acidosis in children patients with acute gastroenteritis. Methods A total of 156 children patients with acute gastroenteritis dehydration treated in our hospital were selected. The concentrations of blood ketone and serum bicarbonate were detected before the first administration. The degree of dehydration in children patients was graded according to dehydration scores, and the degree of metabolic acidosis was graded according to the concentration of serum bicarbonate. The concentrations of blood ketone in children patients with different degrees of dehydration and acidosis were compared. The correlation between the concentration of blood ketone and dehydration scores and the concentration of serum bicarbonate was analyzed. Results The blood ketone in children patients increased significantly with the increase of the dehydration degree(P < 0.05) and that of the degree of metabolic acidosis(P < 0.05).The concentration of blood ketone was positively correlated to dehydration scores(r=0.878, P=0.000) and negatively correlated to the concentration of serum bicarbonate(r=-0.605, P=0.000). Conclusion The blood ketone in children patients with acute gastroenteritis dehydration is positively correlated to the dehydration scores and negatively correlated to the concentration of serum bicarbonate;blood ketone monitoring can be used to preliminarily evaluate the conditions of dehydration and metabolic acidosis in children patients with acute gastroenteritis.