β-HB、LAC、Lp-PLA2水平监测对糖尿病酮症酸中毒合并感染的影响

doi:10.16689/j.cnki.cn11-9349/r.2020.01.017

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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.

Key words： Diabetic ketoacidosis Infection Beta-hydroxybutyric acid Lactic acid Lipoprotein-associated phospholipase A2 Correlation

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	Articles by authors
	1Wang Chunyan
	2Gu Wei
	2Hou Liping
	2Geng Jianlin
	2Zhang Xuekun

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1Wang Chunyan,2Gu Wei,2Hou Liping, et al. Effect of β-HB, LAC, Lp-PLA2 level monitoring on diabetic ketoacidosis combined infection[J]. Electron J Metab Nutr Cancer, 2020, 7(1): 93-97.

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http://182.92.200.144/EN/10.16689/j.cnki.cn11-9349/r.2020.01.017 OR http://182.92.200.144/EN/Y2020/V7/I1/93

1.Umpierrez GE. Diabetes：SGLT2 inhibitors and diabetic ketoacidosis—a growing concern.Nat Rev Endocrinol.2017；13(8)：441-442.
2.石辉进, 罗远辉, 刘义学, 等. 胰岛素泵与持续静脉应用胰岛素对糖尿病酮症酸中毒患者酮体代谢、血气指标及应激状态的影响. 海南医学院学报.2017；23(17)：2349-2352.
3.Peters AL, Buschur EO, Buse JB,et al. Euglycemic diabetic ketoacidosis： a potential complication of treatment with sodium-glucose cotransporter 2 inhibition. Diabetes Care. 2015；38(9)：1687-1693.
4.Andrews TJ,Cox RD,Parker C,et al.Euglycemic Diabetic Ketoacidosis with Elevated Acetone in a Patient Taking a Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitor.J Emerg Med.2017；52(2)：223-226.
5.张红娟,张丹.糖尿病酮症酸中毒并发症的相关实验室检查.中国临床医生杂志.2017；45(1)：18-21.
6.Goldenberg RM, Berard LD, Cheng YY, et al. SGLT2 Inhibitor-associated diabetic ketoacidosis： clinical review and recommendations for prevention and diagnosis. Clin Ther.2016；38(12)：2654-2664.
7.吴晓艳,刘军,沈清,等. 降钙素原与乳酸水平的监测在糖尿病酮症酸中毒合并感染中的相关分析. 临床急诊杂志. 2017；18(3)：225-228.
8.杨惠岚, 袁高品, 邓浩, 等. 血清β-羟丁酸在糖尿病酮症/酮症酸中毒中的诊断价值. 四川大学学报(医学版). 2014；45(2)：270-273.
9.宋军俊. 乌司他丁联合血液透析治疗糖尿病酮症酸中毒的疗效观察. 现代药物与临床.2016；31(12)：1950-1954.
10.Wong CW, Lee JS, Tam KF,et al. Diabetes in older people： position statement of The Hong Kong Geriatrics Society and the Hong Kong Society of Endocrinology, Metabolism and Reproduction. Hong Kong med J. 2017；23(5)：524-533.
11.中华医学会糖尿病学分会. 中国高血糖危象诊断与治疗指南. 中华糖尿病杂志. 2013；5(8)：449-461.
12.Perry R J, Peng L, Abulizi A, et al. Mechanism for leptins acute insulin-independent effect to reverse diabetic ketoacidosis. J Clin Invest. 2017；127(2)：657-669.
13.Fazeli Farsani S,Brodovicz K,Soleymanlou N,et al. Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D)：A systematic literature review. BMJ Open.2017；7(7)：e016587.
14.Guisado-Vasco P, Cano-Megías M, Carrasco-de la Fuente M, et al. Clinical features, mortality, hospital admission, and length of stay of a cohort of adult patients with diabetic ketoacidosis attending the emergency room of a tertiary hospital in Spain. Endocrinol Nutr. 2015；62(6)：277-284.
15.吴晓艳, 刘军, 沈清, 等. 降钙素原与乳酸水平的监测在糖尿病酮症酸中毒合并感染中的相关分析. 临床急诊杂志. 2017；18(3)：225-228.
16.罗江, 施剑青. 血小板/淋巴比值与糖尿病酮症酸中毒预后的相关性研究. 中华内分泌外科杂志. 2018；12(6)：473-477.
17.罗金花, 王娇, 孙嘉, 等. 末梢血β-羟丁酸对糖尿病酮症酸中毒诊断价值的Meta分析.中国糖尿病杂志. 2014；22(10)：934-937.
18.施耀方, 邹建英. 末梢血β-羟丁酸与尿酮体测定在糖尿病酮症预后及诊断中的研究. 护士进修杂志. 2012；27(22)：2066-2067.
19.王路岩, 王俊俊, 李砚文. 血清PCT、LAC水平检测在糖尿病酮症酸中毒合并院内获得性肺炎患者疗效评估中的应用. 中国实用医刊. 2017；44(24)：66-68.
20.陈学军. 糖尿病酮症酸中毒患者血清β-羟丁酸检测水平分析. 中国实验诊断学. 2016；20(4)：580-582.
21.杨秀兰, 朱星成. 血清β-羟丁酸测定在糖尿病酮症酸中毒中的临床应用价值. 中国临床新医学. 2016；9(3)：247-249.
22.李佳,姜鲜, 马红艳. 血清降钙素原的动态变化对糖尿病酮症酸中毒感染的诊断价值.实用医学杂志. 2016；32(10)：1650-1653.
23.黄斌, 陈超, 杨胜菊, 等. 降钙素原乳酸比对糖尿病酮症酸中毒感染的预测价值. 中华糖尿病杂志. 2018；10(8)：548-551.
24.龙训琴, 高建萍, 刘韧, 等. 血清β-羟丁酸和乳酸联合检测在糖尿病酮症酸中毒诊断中的价值. 四川医学. 2015；36(10)：1467-1470.
25.王忠勇, 赵宏胜, 张彬, 等. 严重感染患者血乳酸及混合静脉血氧饱和度与预后相关性研究. 中国急救医学. 2010；30(7)：599-601.
26.张琛, 魏义. 血必净在糖尿病酮症酸中毒合并感染患者的疗效观察. 临床检验杂志(电子版). 2017；6(2)：368.
27.陈运龙, 刘川, 刘小燕, 等. 脂蛋白相关磷脂酶A2、糖化血红蛋白水平与糖尿病患者冠脉病变程度的相关性分析. 第三军医大学学报. 2018；40(12)：1136-1141.
28.朱红云, 鞠海兵, 王爽, 等. 糖尿病视网膜病变患者血清脂蛋白相关磷脂酶A2水平变化及其相关因素分析. 中国糖尿病杂志.2017；25(8)：707-710.
29.柯成能,王丽, 肖红刚. 同型半胱氨酸、脂蛋白相关磷脂酶A2与2型糖尿病合并冠心病的相关研究. 中国现代药物应用. 2015；9(12)：17-18,19.
30.雷鸣, 夏丹妮, 汤兰桂, 等. 幽门螺杆菌感染对颈动脉粥样硬化患者血清脂蛋白相关磷脂酶A2水平及颈动脉斑块稳定性的影响. 中国医师杂志. 2015；17(10)：1505-1508.