六例糖尿病酮症酸中毒合并高脂血症和急性胰腺炎临床分析  

Clinical Analysis in 6 cases of diabetic ketoacidosis complicated with hyperlipidemia and acute pancreatitis

作　　者：陆泽元[1] 邵豪[1] 杨冀衡[2] 赖丽萍[1] 姚壮鑫[1] 邹钢[1] 柳岚[1] 庄雄杰[1] 

机构地区：[1]广东医学院附属福田人民医院内分泌科,深圳518033 [2]广东医学院附属福田人民医院心血管内科,深圳518033

出　　处：《中华内分泌代谢杂志》2007年第1期81-84,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的提高临床医师对糖尿病酮症酸中毒（DKA）合并高脂血症（HL）和急性胰腺炎（AP）的认识。方法回顾性分析6例DKA合并HL和AP患者的临床资料。结果除DKA的临床特征外，还有：（1）6例患者均为中青年，年龄（34．24±4．1）岁，以急性腹痛就诊，均有腹部压痛；（2）入院时均有HL，次晨查甘油三酯（14．2～62．2mmol／L），总胆固醇（8．9～29．4mmot／L），治疗48-72h后甘油三酯降至（1．98～5．39mmol／L），总胆固醇降至（4．52～7．36mmol／L）；（3）AP发作期间5例患者血和（或）尿淀粉酶升高3倍以上，仅1例患者升高不到1倍；5例患者胰腺CT检查有AP改变，但其中3例患者B超显示胰腺正常；（4）治愈的5例患者以及时有效地纠正DKA和禁食治疗为基本措施，治疗后腹痛消失，血尿淀粉酶恢复正常。结论（1）以腹痛就诊的DKA患者，应查甘油三酯、血尿淀粉酶和腹部CT以排除AP；（2）纠正DKA和禁食是治疗暂时性显著HL和AP的关键。Objective To enhance the understanding of diabetic ketoacidosis （DKA） complicated with hyperlipidemia and acute pancreatitis（AP） . Methods Clinical and laboratory data of six patients diagnosed as DKA complicated with hyperlipidemia and AP in our hospital from 1998 to 2006 were retrospectively analyzed. Results These patients showed clinical feature of DKA and some other characteristics. （ 1 ） Six patients, aged （34.2 ± 4. 1 ） years were admitted with main complaint of acute abdominal pain. （2） Six patients had hyperlipidemia at admission. Lipid profile was determined in the second morning for each patient, triglycerides were elevated to （ 14.2-62.2 mmol/L） and total cholesterols to （8.9-29.4 mmol/L）. Serum triglycerides level dropped to （ 1.98-5.39 mmol/L） and total cholesterols to （4.52-7.36 mmol/L） after the treatment for 48 to 72 hours. （3） Serum and/or urinary amylase levels were more than three times to normal in five patients, and less than double in one patient. Abdominal CT revealed AP in five patients, but abdominal ultrasound did not show any abnormalities in three of them. （4） With effective treatment the five patients recovered, abdominal pain disappeared and serum amylase returned to normal level. Conclusions Once the patients had abdominal pain accompanied with DKA, triglyceride and amylase levels should be checked, and abdominal CT scan should be performed to rule out AP. The effective treatment could bring about a resolution of hyperlipidemia and cessation of AP.

关 键 词：糖尿病酮症酸中毒 高脂血症 高甘油三酯血症 急性胰腺炎 

分 类 号：R686[医药卫生—骨科学]