1Department of Endocrinology of Fourth Peoples Hospital of Hengshui City, Hengshui 053000, Hebei, China； 2Department of Endocrinology of Hengshui Harrison International Peace Hospital, Hengshui 053000, Hebei, China
Abstract：Objective To investigate the effects of β-hydroxybutyric acid, lactic acid (LAC), and lipoprotein-associated phospholipase A2 (Lp-PLA2) level monitoring on diabetic ketoacidosis (DKA) combined infection. Methods From May 2018 to May 2019, 100 inpatients with DKA infection in our hospital and other municipal hospitals in endocrinology department, intensive medicine department, and emergency ICU were selected as the DKA infection group, 100 cases without DKA were selected as DKA infection-free group, and 50 patients with diabetes mellitus were selected as DM group. After admission, blood samples were taken from each patient. Serum Lp-PLA2 level was determined by immunoenhancement turbidimetry, serum beta-HB level was determined by automatic blood gas analyzer, serum LAC level was determined by enzymatic colorimetry, and basic treatment such as fluid infusion, hypoglycemia,ketone correction and acid correction was given to DKA infected patients. The serum levels of beta-HB, LAC and Lp-PLA2 were measured before and after treatment in three groups, and DKA infected patients with different degrees of disease and DKA infected group. The correlation between serum indicators and the degree of DKA infection was analyzed. Results (1) Three groups of serum indicators：the serum levels of serum beta-HB,LAC and Lp-PLA2 in DKA infection-free group were higher than those in DM group, and the serum levels of beta-HB, LAC and Lp-PLA2 in DKA infection group were higher than those in DKA infection-free group (P<0.05)； (2) Serum indicators of DKA infection in different severities：the serum levels of beta-HB, LAC and Lp-PLA2 in moderate patients were higher than those in mild patients and severe patients. Serum levels of beta-HB, LAC and Lp-PLA2 were higher than those of moderate (P<0.05)； (3) Serum indexes of DKA infected patients before and after treatment：After treatment, serum levels of beta-HB,LAC and Lp-PLA2 in DKA infected group were lower than those before treatment (P<0.05)； (4) Relevance：There was a significant positive relative correlation between serum levels of beta-HB,LAC and Lp-PLA2 and the severity of DKA infection (P<0.05). Conclusions Serum levels of beta-HB,LAC and Lp-PLA2 are positively correlated with the severity of DKA combined infection. Clinical examination of serum levels of beta-HB,LAC and Lp-PLA2 can provide evidence-based support for evaluating the severity of infection and symptomatic treatment.
