老年人糖尿病酮症酸中毒时测定血尿素氮和pH值的临床意义

DETECTED AND SIGNIFICANCE OF BLOOD UREA NITROGEN AND pH FROM AGED DIABETIC KETOACIDOSIS PATIENTS

目的 :评价有关生化检测指标在老年人糖尿病酮症酸中毒时对病情预后判断的作用。方法 :收集 5年来老年人糖尿病酮症酸中毒 (DKA)住院患者 3 2例 ,对其发病诱因、血糖、血尿素氮 (BU N)、血 p H值、阴离子间隙 (AG)、血渗透压、糖化血红蛋白(Hb A1 C)等多项指标进行回顾性分析。结果 :老年人 DKA发病的诱因以感染为多见 ,误用葡萄糖诱发 DKA或加重病情并不少见 ;死亡组患者血 p H值显著降低 (7.14± 0 .16) ,BU N明显增高 [(14 .8± 8.0 mm ol/ L) ],与存活组比较有显著性差异 (P <0 .0 5 ) ,但两组间血糖、Hb A1 C、血渗透压、AG、血 K+、血 Na+等差异不明显 (P>0 .0 5 )。结论 :测定老年 DKA患者血 p H值及血 BUN对估计病情及进行有效治疗有一定的指导意义。

Objective:To investigate whether the level of blood gas analysis and blood biochemical analysis from aged diabetic ketoacidosis patients could be used as a marker for assessing disease's severity and helping in earlier diagnosis and salvage therapy Methods:All blood samples were obtained from 32 aged diabetic ketoacidosis patients and measured immediately after hospitalization Concentrations of blood glucose, blood urea nitrogen, pH, anion gap, blood osmotic pressure and HbA 1C were detected and disease's predisposition was analysised The relationship between detected results and patients'prognosis was analysised and estimated by retrospective study Results:Bacteria infection was the most important cause in aged diabetic ketoacidosis inpatients, moreover, wrongly intravenous infusing glucose was another common cause which trigger disease or worsen patient's condition Significant difference in levels of blood urea nitrogen and pH were found between survival group and dead group, which meaned that patient's mortality was correlated to levels of blood urea nitrogen and pH,but unrelated to blood glucose, anion gap, blood osmotic pressure or HbA 1C Conclusion:detecting the level of blood urea nitrogen and pH will be helpful for estimating the severity of aged diabetic ketoacidosis and deciding on diagnosis and earlier salvage therapy