1型糖尿病患儿血清胆红素水平变化的临床意义  

The changes and clinical significance of serum bilirubin in children with type 1 diabetes mellitus

作　　者：陈晓娟 蔚京京[2] Chen Xiaojuan;Wei Jingjing(Department of Endocrinology and Genetic Metabolism,Children′s Hospital of Shanxi Province(Women Health Center of Shanxi Province),Taiyuan 030013,China;Department of Pediatrics,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西省儿童医院(山西省妇幼保健院)内分泌遗传代谢科,太原030013 [2]山西医科大学儿科医学系,太原030001

出　　处：《中华实用儿科临床杂志》2020年第20期1557-1560,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的:探讨1型糖尿病(T1DM)患儿胆红素水平的变化及临床意义。方法:选取2015年1月至2019年8月在山西省儿童医院内分泌遗传代谢科住院的142例T1DM患儿为T1DM组,又根据病程分为新诊断组(此次入院初次诊断为T1DM)45例和病程稍长组(诊断为T1DM>1年)97例。选取同期体检的健康儿童140例作为健康对照组,比较2组间总胆红素、结合胆红素和非结合胆红素水平的差异,计算各组总胆红素值>25.14 μmol/L的人数比例,并使用 Pearson相关性分析方法分析T1DM组总胆红素和非结合胆红素水平与病程、糖化血红蛋白水平的相关性。 结果:1.T1DM组患儿总胆红素、结合胆红素及非结合胆红素水平分别为(12.62±6.29) μmol/L、(2.46±1.27) μmol/L、(10.15±5.18) μmol/L,均高于对照组[(10.36±3.36) μmol/L、(1.94±1.00) μmol/L、(8.41±3.05) μmol/L],差异均有统计学意义(均 P<0.05);其总胆红素>25.14 μmol/L的人数比例(7.1%)高于对照组(0),差异有统计学意义( P<0.05)。2.病程稍长组患儿糖化血红蛋白水平[(8.93±1.78)%]低于新诊断组[(10.94±2.68)%],而其非结合胆红素水平[(10.65±5.88) μmol/L]及其总胆红素浓度>25.14 μmol/L的人数比例(10.30%)均高于新诊断组[(9.06±3.00) μmol/L、0],差异均有统计学意义(均 P<0.05)。3. Pearson相关性分析显示,T1DM组总胆红素水平与病程呈负相关( r=-0.218, P<0.05),但总胆红素和非结合胆红素水平均与糖化血红蛋白水平无相关性(均 P>0.05)。 结论:胆红素在T1DM患儿发病初期及病程进展中的水平逐渐增高,推测血清胆红素可能作为临床判断T1DM患者体内抗氧化水平的参考指标之一。Objective To explore the changes and clinical significance of bilirubin in children with type 1 diabetes mellitus.Methods A total of 142 inpatients diagnosed with type 1 diabetes mellitus in the Endocrinology and Genetics Metabolism Department of Shanxi Children′s Hospital from January 2015 to August 2019 were enrolled in the diabetes mellitus group of this study.These patients were subdivided into the newly diagnosed group(45 cases,who were newly diagnosed with type 1 diabetes mellitus)and the group with a longer course(97 cases,who were diagnosed with type 1 diabetes mellitus for over 1 year)according to the course of disease.Another 140 healthy children undergoing physical examination at the same time were treated as the control group.The levels of total,conjugated and unconjugated bilirubin between the control group and the diabetes mellitus group were analyzed statistically.The proportions of patients with the total bilirubin value>25.14μmol/L in each group were calculated.The correlation of the levels of total and indirect bilirubin with the disease duration and glycated hemoglobin(HbA1C)in the diabetes mellitus group was analyzed by Pearson correlation.Results(1)The levels of total,conjugated and unconjugated bilirubin in the diabetes mellitus group were(12.62±6.29)μmol/L,(2.46±1.27)μmol/L,and(10.15±5.18)μmol/L,respectively,which were all significantly higher than those in the control group[(10.36±3.36)μmol/L,(1.94±1.00)μmol/L,and(8.41±3.05)μmol/L],and the differences were all significant(all P<0.05).The proportion of patients with total bilirubin>25.14μmol/L(7.1%)in the diabetes mellitus group was significantly higher than that in the control group(0)(P<0.05).(2)The HbA1C level of the group with a longer course[(8.93±1.78)%]was significantly lower than that of the newly diagnosed group[(10.94±2.68)%],while the unconjugated bilirubin levels[(10.65±5.88)μmol/L]and the proportion of patients with total bilirubin>25.14μmol/L(10.30%)in the diabetes mellitus group were all significantly hig

关 键 词：1型糖尿病 总胆红素 非结合胆红素 

分 类 号：R725.8[医药卫生—儿科]