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目的分析2型糖尿病(T2DM)患者并发糖尿病酮症(DK)的诱发因素。方法选取2011年6月—2015年6月在浙江省糖尿病防治中心接受治疗的T2DM并发DK患者545例,将其中新诊断为酮症倾向2型糖尿病(KPD)297例患者纳入KPD组,非新诊断KPD的患者248例纳入T2DM组,收集两组患者的年龄、性别、诱发因素、血压和糖化血红蛋白(Hb A1c)等临床资料进行回顾性分析。结果 KPD组患者并发DK最主要的诱因为长期未予干预(71.71%),其次为感染(15.15%);T2DM组患者并发DK最主要的诱因为未及时调整治疗方案(39.91%),其次为自行停药(22.98%)和感染(20.97%)。KPD组患者平均年龄和BMI值小于T2DM组患者(均P<0.01);KPD组患者Hb A1c水平、严重酮症(尿酮≥++)及合并DK的比例高于T2DM组患者(均P<0.05)。结论应对KPD患者加强糖尿病防治知识教育及高危人群筛查;对已确诊的T2DM患者加强随访和监测。
Objective To analyze the predisposing factors of diabetic ketosis (DK) in type 2 diabetes mellitus (T2DM). METHODS: From June 2011 to June 2015, 545 T2DM patients with DK treated in Diabetes Prevention and Treatment Center of Zhejiang Province were enrolled. 297 newly diagnosed ketosis-prone type 2 diabetes (KPD) patients were included in the KPD group, A total of 248 patients with KPD were included in the T2DM group. The clinical data including age, gender, predisposition, blood pressure and HbA1c were collected and retrospectively analyzed. Results The most common causes of DK in patients with KPD were long-term intervention (71.71%) and infection (15.15%). The main cause of DK in patients with T2DM was delayed treatment (39.91%), followed by Drug withdrawal (22.98%) and infection (20.97%). The mean age and BMI of patients in KPD group were lower than that of T2DM patients (all P <0.01). The levels of Hb A1c, severe ketosis (K + ≥ ++) and combined DK in KPD patients were higher than those in T2DM patients ). Conclusion KPD patients should strengthen the knowledge of diabetes prevention and treatment of screening and screening of high-risk groups; to strengthen the follow-up and monitoring of T2DM patients have been diagnosed.