学龄期1型糖尿病患儿发生酮症酸中毒的影响因素研究

Study on the Influencing Factors of Ketoacidosis in School-age Children with Type 1 Diabetes

目的探索影响学龄期1型糖尿病患儿发生糖尿病酮症酸中毒的危险因素,以期降低此类患儿酮症酸中毒的发生率。方法选择2019年1月~2020年10月我院收治的52例学龄期1型糖尿病儿童作为未发生组,另外选择同期我院收治的45例学龄期1型糖尿病合并酮症酸中毒儿童作为发生组,自制基线资料调查量表,收集两组基线资料,采用Logistic回归分析影响学龄期1型糖尿病患儿发生酮症酸中毒的危险因素。结果两组年龄、性别、家族史比较,差异无统计学意义(P>0.05);发生组前驱感染、延误诊断发生率高于未发生组,C肽、BMI水平低于未发生组,差异有统计学意义(P<0.05);Logistic回归分析显示,学龄期1型糖尿病儿童合并前驱感染、延误诊断、C肽水平较低、BMI较低是导致其发生酮症酸中毒的危险因素(OR=10.651、2.648、4.985、15.284,P<0.05)。结论前驱感染、延误诊断、C肽及BMI水平均与1型糖尿病酮症酸中毒密切相关,应制定针对性干预措施,以降低酮症酸中毒的发生风险。

Objective To explore the risk factors of diabetic ketoacidosis in school-age children with type 1 diabetes,in order to reduce the incidence of ketoacidosis in such children.Methods 52 school-age type 1 diabetes children admitted to our hospital from January 2019 to October 2020 were selected as the non-occurring group.In addition,45 school-age children with type 1 diabetes and ketoacidosis admitted to our hospital during the same period were selected as the occurrence group,and the baseline data survey scale was self-made,and the baseline data of the two groups were collected.Logistic regression analysis was used to analyze the risk factors of ketoacidosis in school-age children with type 1 diabetes.Results There was no statistically significant difference between the two groups in age,gender,and family history(P>0.05);The incidence of pre-infection and delayed diagnosis in the occurrence group was higher than that of the non-occurring group,and the levels of C peptide and BMI were lower than those of the non-occurring group,the difference was statistically significant(P<0.05);Logistic regression analysis showed that pre-infection,delayed diagnosis,low C-peptide levels,and low BMI were risk factors for ketoacidosis in school-age children with type 1 diabetes(OR=10.651,2.648,4.985,15.284,P<0.05).Conclusion Pre-infection,delayed diagnosis,C-peptide and BMI levels are closely related to type 1 diabetic ketoacidosis,and targeted intervention measures should be developed to reduce the risk of ketoacidosis.