糖尿病酮症酸中毒患者AMS升高的高危因素分析

Analysis on High Risk Factors for Elevated AMS in Patients with Diabetic Ketoacidosis

目的:探究糖尿病酮症酸中毒(DKA)患者血淀粉酶(AMS)升高的高危因素。方法:选取2016年2月到2018年12月我院收治的210例DKA患者作为研究对象,根据AMS是否升高分为观察组(AMS升高,n=60)和对照组(AMS正常,n=150),检测患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、尿素氮(BUN)、血肌酐(Scr)、二氧化碳结合力(CO_(2)CP)、血浆渗透压等水平。结果:观察组FPG、TG、HbA1c、血浆渗透压、BUN、Scr水平均高于对照组,差异具有统计学意义(P<0.05),两组患者年龄、病程、TC、CO_(2)CP比较差异无统计学意义(P>0.05);相关分析显示,AMS升高与FPG、TG、血浆渗透压、BUN具有相关性(P<0.05),与年龄、病程、TC、CO_(2)CP、Scr和HbA1c无相关性(P>0.05);Logistic回归分析显示TG水平(OR=1.612,95%CI:1.214-2.141)是DKA患者AMS升高的独立危险因素(P<0.05)。结论:TG含量升高是DKA患者AMS升高的高危因素,临床诊疗中应针对高危因素进行筛查,减少并发症发生。

Objective: To investigate the high risk factors of elevated blood amylase(AMS) in patients with diabetic ketoacidosis(DKA).Methods:A total of 210 patients with DKA admitted in our hospital from February 2016 to December2018 were divided into observation group(elevated AMS,n=60) and control group(normal AMS,n=150) according to AMS status.The levels of fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c),triglyceride(TG),total cholesterol(TC),urea nitrogen(BUN),serum creatinine(Scr),carbon dioxide binding(CO_(2)CP) plasma osmotic pressure were detected.Results:The levels of FPG,TG,HbA1 c,plasma osmotic pressure,BUN and Scr in the observation group were higher than those in the control group(P<0.05).There was no significant difference in age, duration, TC and CO_(2)CP between the two groups(P>0.05).Correlation analysis showed that elevated AMS was associated with FPG,TG,plasma osmotic pressure and BUN(P<0.05),and not associated with age,duration,TC,CO_(2)CP,Scr and HbA1 c(P>0.05). Logistic regression analysis showed that TG levels(OR=1.612,95% CI:1.214-2.141) were independent risk factors for elevated AMS in patients with DKA(P<0.05).Conclusions:The elevated TG level is a high risk factor for elevated AMS in patients with DKA.Screening for high risk factors should be performed in clinical diagnosis and treatment to reduce complications.