论文部分内容阅读
目的评估分析糖尿病酮症(DK)和糖尿病酮症酸中毒(DKA)患者临床异质性和自身免疫状况。方法回顾性分析2000年1月1日-2008年12月31日四川大学华西医院住院DK/DKA患者临床资料,分析其临床分型、临床生物化学和自身免疫特点。结果共筛出1 710例DK/DKA住院糖尿病患者,其中2型糖尿病(T2DM)患者883例,占51.6%(T2DM组),高于1型糖尿病(T1DM)患者的构成比(257例,15.0%)(T1DM组),另有515例(30.1%)未分型或归属“不典型糖尿病”(ADM组)。T2DM组患者平均年龄为(58.1±13.2)岁,T1DM组平均年龄为(31.1±13.5)岁,差异有统计学意义(P<0.001)。感染是DK/DKA最常见的诱因,其次是患者依从性差。ADM组患者谷氨酸脱羧酶抗体阳性率为4.37%,与T2DM组接近(2.69%,P=0.79),低于T1DM组(13.79%,P<0.001)。结论 DK或DKA不仅在T1DM患者发生,而且T2DM患者也可能发生。DK/DKA患者存在较大的临床异质性,自身免疫状态和胰岛β细胞功能评估有助于临床分型。
Objective To assess the clinical heterogeneity and autoimmunity in patients with diabetic ketosis (DK) and diabetic ketoacidosis (DKA). Methods The clinical data of hospitalized patients with DK / DKA in West China Hospital of Sichuan University from January 1, 2000 to December 31, 2008 were retrospectively analyzed. The clinical classification, clinical biochemistry and autoimmunity were analyzed. Results A total of 1 710 DK / DKA inpatients with diabetes were enrolled, of whom 883 (51.6%) had type 2 diabetes mellitus (T2DM) and more than those with type 1 diabetes (257 patients, 15.0% %) (T1DM group), and another 515 patients (30.1%) were classified or attributed to “atypical diabetes” (ADM group). The average age of T2DM patients was (58.1 ± 13.2) years old, and the average age of T1DM patients was (31.1 ± 13.5) years old, the difference was statistically significant (P <0.001). Infection is the most common cause of DK / DKA, followed by poor patient compliance. The positive rate of glutamic acid decarboxylase antibody in ADM group was 4.37%, which was close to T2DM group (2.69%, P = 0.79), lower than T1DM group (13.79%, P <0.001). Conclusion DK or DKA not only occurs in T1DM patients, but also T2DM patients may occur. Patients with DK / DKA have a large clinical heterogeneity, and their autoimmune status and assessment of pancreatic β-cell function contribute to clinical classification.