CAJ | 학술논문

【目的】探讨血清β-羟丁酸在糖尿病酮症酸中毒(diabetes mellitus ketoacidosis,DKA)患者中的诊断与病情的评估价值。【方法】选取 DKA 患者33例,根据病情程度分为轻、中、重,比较不同程度 DKA 患者β-羟丁酸水平、pH 值及碳酸氢离子浓度[HCO 3-],分析β-羟丁酸水平与 pH 值、[HCO 3-]的相关性。【结果】血清β-羟丁酸水平随着病情的加重而增高,pH 及[HCO 3-]水平随着病情的加重下降,组间比较均有统计学意义(P <0.05)。相关性分析显示β-羟丁酸水平与 pH 及[HCO 3-]的水平均呈负相关关系(r=-0.8260,P =0.000；r=-0.7750,P =0.000)。性能评价结果显示β-羟丁酸为3.0 mmol/L 时,有效性最高,为84.91%,此时灵敏度为0.99,特异性为0.78；结合血糖浓度≥13.9 mmol/L,β-羟丁酸为3.0 mmol/L 时的有效性最高,为92.81%,此时灵敏度为0.99,特异性为0.86。【结论】血清β-羟丁酸≥3.0 mmol/L 可作为诊断DKA 的阈值,且可将β-羟丁酸水平作为 DKA 严重程度的判断指标。
【목적】탐토혈청β-간정산재당뇨병동증산중독(diabetes mellitus ketoacidosis,DKA)환자중적진단여병정적평고개치。【방법】선취 DKA 환자33례,근거병정정도분위경、중、중,비교불동정도 DKA 환자β-간정산수평、pH 치급탄산경리자농도[HCO 3-],분석β-간정산수평여 pH 치、[HCO 3-]적상관성。【결과】혈청β-간정산수평수착병정적가중이증고,pH 급[HCO 3-]수평수착병정적가중하강,조간비교균유통계학의의(P <0.05)。상관성분석현시β-간정산수평여 pH 급[HCO 3-]적수평균정부상관관계(r=-0.8260,P =0.000；r=-0.7750,P =0.000)。성능평개결과현시β-간정산위3.0 mmol/L 시,유효성최고,위84.91%,차시령민도위0.99,특이성위0.78；결합혈당농도≥13.9 mmol/L,β-간정산위3.0 mmol/L 시적유효성최고,위92.81%,차시령민도위0.99,특이성위0.86。【결론】혈청β-간정산≥3.0 mmol/L 가작위진단DKA 적역치,차가장β-간정산수평작위 DKA 엄중정도적판단지표。
[Objective]To explore the value of serumβ-hydroxybutyrate(βOHB)in the diagnosis and state assessment of patients with diabetic ketoacidosis(DKA).[Methods]A total of 33 patients with DKA were cho-sen.According to the severity of DKA,all patients were divided into mild,middle and severe group.The level ofβOHB pH value and [HCO 3 - ]among patients with mild,middle and severe DKA were compared.The re-lationship ofβOHB with pH value and [HCO 3 - ]was analyzed.[Results]SerumβOHB increased with the ag-gravation of DKA,while pH value and [HCO 3 - ]decreased with the aggravation of DKA.There was signifi-cant difference between two groups(P <0.05).The correlation analysis showed that serum βOHB was nega-tively related with pH value and [HCO 3 - ](r =-0.8260,P =0.000;r =-0.7750,P =0.000).Perform-ance evaluation results showed that when serum βOHB was 3.0mmol/L,the effectiveness was the highest (84.91%),and the sensitivity was 0.99,and the specificity was 0.78.When blood glucose was more than 13.9 mmol/L andβOHB was 3.0mmol/L,the effectiveness was the highest(92.81%),and the sensitivity was 0.99 and the specificity was 0.86.[Conclusion]SerumβOHB ≥ 3.0mmol/L can be used as the diagnostic threshold of DKA.Serum βOHB may be the indicator of severity assessment of DKA.