快速血酮检测对糖尿病酮症酸中毒的临床意义

发布时间：2018-02-09 16:45

本文关键词： 糖尿病酮症酸中毒末梢血β－羟丁酸尿酮体　出处：《吉林大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：对比研究快速血酮（末梢血β-羟丁酸）测定和尿酮体测定对糖尿病酮症酸中毒的诊断及治疗的临床意义。方法：在2012年1月到2013年12月期间，于入院的患者中，筛选糖尿病酮症酸中毒患者（Diabetic ketoacidosis，DKA组）50例，糖尿病非酮症组（Non-diabetic ketosis,NDK组）100例,同时筛选健康体检者100例做为参照组。检测以上三组人员末梢血β-羟丁酸(β-hydroxybutyricacid,β-HBA)、空腹血糖(Fasting plasma glucose, FPG)以及尿酮体，并对所测得结果进行比较分析。并且检测DKA组在经过补液、调糖、对症治疗前后末梢血β-HBA、FBG及尿酮体数值，并对结果进行比较分析。结果：1、糖尿病非酮症组中的血β-羟丁酸阳性例数较尿酮体阳性例数多，P 0.05，差异有统计学意义； DKA组与NDK组、健康组相比较，末梢血β-羟丁酸值明显高于其他两组,血糖值、尿酮体检测水平也明显高于其他两组，P 0.01，差异有统计学意义；健康对照组中尿酮体出现2例的阳性。2、DKA组治疗后末梢血β-羟丁酸值较治疗前明显降低，与治疗前相比较，差异有显著性意义(P 0.05)；治疗后尿酮体阳性数5例。3、末梢血β-羟丁酸浓度与血糖浓度成显著正相关性(分别为r=0.608,P0.01)。结论：1、NDK组中末梢血β－羟丁酸检测阳性例数高于尿酮体阳性例数，末梢血β－HBA测定可早期发现其升高趋势，对早期诊断有重要意义。2、DKA组较其他两组，，末梢血β-HBA值、血糖值、尿酮体检测水平明显高于其他两组，末梢血β－羟丁酸检测比尿酮体检测准确度好。3、DKA组治疗后较治疗前，末梢血β-HBA值较治疗前明显降低，尿酮体阳性数5例，说明末梢血β-HBA可较准确地评价治疗效果。4、末梢血β-羟丁酸浓度与血糖浓度成显著正相关，临床上可联合检测血糖，能够较好的控制病情进展。
[Abstract]:Objective: to study the clinical significance of rapid determination of beta-hydroxybutyric acid (尾 -hydroxybutyric acid) in peripheral blood and determination of urinary ketone body in the diagnosis and treatment of diabetic ketoacidosis. Methods: from January 2012 to December 2013, 50 patients with diabetic ketoacidosis and 100 patients with non-diabetic ketoacidosis NDK were selected. The peripheral blood 尾 -hydroxybutyric acid (尾 -HBAd), fasting plasma glucose (FPGs) and urine ketone body were detected in the three groups, and the results were compared and analyzed. The peripheral blood 尾-HBA- FBG and urinary ketone body were compared before and after symptomatic treatment. Results the blood 尾 -hydroxybutyric acid (尾 -hydroxybutyric acid) positive rate in non-ketosis group was significantly higher than that in urine ketone body positive group (P 0.05), and the serum 尾 -hydroxybutyric acid (尾 -hydroxybutyric acid) level in DKA group was significantly higher than that in NDK group and healthy group (P 0.05), and the blood glucose level was significantly higher in DKA group than in other two groups. The level of urinary ketone body was also significantly higher than that of the other two groups (P 0.01), and the level of 尾 -hydroxybutyric acid (尾 -hydroxybutyric acid) in the peripheral blood of 2 cases with positive urethral ketone body appeared in the healthy control group after treatment was significantly lower than that before treatment, which was significantly lower than that before treatment. The positive number of urinary ketobutyric acid (尾 -hydroxybutyric acid) in peripheral blood was positively correlated with blood glucose concentration (r = 0.608) (P 0.01). Conclusion the detection of 尾 -hydroxybutyric acid in peripheral blood is higher than that in urine ketone body in the group of 0.608 渭 g / min ~ (-1) NDK (P < 0.05), and the positive rate of 尾 -hydroxybutyric acid in peripheral blood is higher than that in the group of urine ketone body (P < 0.05). The detection of 尾 -HBA in peripheral blood was significant for early diagnosis. The 尾 -HBA value, blood glucose and urine ketone body level in DKA group were significantly higher than those in the other two groups, and the level of 尾 -HBA in peripheral blood was significantly higher in DKA group than in the other two groups, and the level of 尾 -HBA in peripheral blood was significantly higher than that in other two groups. The accuracy of 尾 -hydroxybutyric acid detection in peripheral blood was better than that in urine ketone body detection. The 尾 -HBA value of peripheral blood in DKA group was significantly lower than that before treatment, and the positive rate of urinary ketone body was 5 cases in DKA group. The results showed that 尾 -HBA in peripheral blood could accurately evaluate the therapeutic effect. The concentration of 尾 -hydroxybutyric acid in peripheral blood was positively correlated with blood glucose concentration.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.2

【参考文献】