糖尿病酮症酸中毒合并高脂血症性急性胰腺炎7例临床分析  

Clinical analysis of 7 cases of diabetic ketoacidosis complicated with hyperlipidemic acute pancreatitis

作　　者：王佩[1] 

机构地区：[1]安徽省蚌埠市第三人民医院内分泌科,233000

出　　处：《淮海医药》2010年第3期208-210,共3页Journal of Huaihai Medicine

摘　　要：目的提高对糖尿病酮症酸中毒(DKA)合并高脂血症(HL)性急性胰腺炎(AP)的诊治水平。方法回顾性分析2003年12月～2009年11月收治的7例DKA合并HL性AP患者的临床资料。结果(1)7例患者均为中青年,年龄(32±6.58)岁;(2)均有腹部压痛,其中4例以明显腹痛为首发症状;(3)均符合DKA诊断标准;(4)均有HL,甘油三酯(TG)≥11.3mmol/L;(5)入院后6例血淀粉酶(AMS)升高,其中4例升至正常3倍以上,1例正常;(6)B超或CT检查共5位患者有胰腺炎改变;(7)予以禁食抑酸及纠正DKA为主的治疗后,患者腹部体征和症状消失,血脂和血淀粉酶均大致恢复正常。结论(1)DKA伴有腹痛或腹部压痛时应常规检查甘油三酯、血尿淀粉酶、胰腺B超或CT:(2)纠正DKA同时予以禁食、抑制胰液分泌是治疗DKA合并HL性AP的关键。Objective To enhance the level of diagnosis and treatment of diabetic ketoacidosis（DKA）complicated with hyperlipidemic acute pancreatitis（AP）. Methods Retrospective analysis was conducted with respect to the clinical data of 7 cases of DKA complicated with hyperlipidemic acute pancreatitis from December 2003 to November 2009.Results （1） All the 7 patients were young people with average age of 32±6.58. （2）All the 7 patients had abdominal tenderness and four of them had abdominal pain as the first symptom. （3）They all accorded with the diagnostic criteria of DKA.（4）They all suffered from hyperlipidemia at admission with serum TG higher than 11.3 mmol/L. （5）6 of them showed elevation of serum amylase at admission.4 cases had 3 times more serum amylase than the normal people. One of the 7 cases had normal serum amylase at admission. （6）Pancreatitis was found in 5 of them by B-ultrasonography and CT.（7）After effective treatment including rectifying DKA ,fasting,acid suppression therapy,the symptoms disappeared and serum amylase recovered to the normal level. Conclusions （1）DKA patients with abdominal pain or abdominal tenderness should undergo tests such as serum TG,serum amylase,pancreatic B-ultrasonography and CT.（2）The effective treatment could bring about a resolution of hyperlipidemia and cessation of AP in the DKA patients complicated with hyperlipidemic AP.

关 键 词：糖尿病酮症酸中毒 高脂血症 甘油三酯血症 急性胰腺炎 

分 类 号：R58[医药卫生—内分泌]