肌酸激酶评估糖尿病酮症酸中毒患者临床结局的价值  

Value of creatine kinase in evaluating clinical outcomes of patients with diabetic ketoacidosis

作　　者：赵永玲 郑超[1] 杨晓荣 ZHAO Yongling;ZHENG Chao;YANG Xiaorong(Department of Endocrinology,Punan Hospital of Shanghai Pudong New Area,Shanghai,200125;Department of Endocrinology,Hangtou Hesha Community Health Service Center of Shanghai Pudong New Area,Shanghai,200125)

机构地区：[1]上海市浦东新区浦南医院内分泌科,上海200125 [2]上海市浦东新区航头鹤沙社区卫生服务中心内分泌科,上海200125

出　　处：《实用临床医药杂志》2020年第21期73-75,85,共4页Journal of Clinical Medicine in Practice

基　　金：上海市浦东新区卫生计生科研项目(PW2017A-26)。

摘　　要：目的探讨肌酸激酶(CK)评估糖尿病酮症酸中毒患者临床结局的价值。方法将40例糖尿病患者分为CK升高的研究组与CK正常的对照组,每组20例。检测并比较2组患者空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血钾、血钠、血尿素氮(BUN)、pH值、血红蛋白(Hb)、碳酸氢根(HCO 3-)、C肽水平。统计2组合并症情况。结果研究组HbA1c、FBG、BUN水平高于对照组,pH值、Hb、HCO 3-水平低于对照组,差异有统计学意义(P<0.05)。入院时,研究组C肽水平低于对照组,差异有统计学意义(P<0.05);出院3个月后,研究组C肽水平高于入院时,差异有统计学意义(P<0.05)。研究组合并糖尿病周围神经病变、糖尿病肾病和糖尿病视网膜病变患者比率高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,CK水平与HbA1c水平呈正相关(r=0.336,P=0.012)。结论糖尿病酮症酸中毒伴CK升高患者的血糖水平明显高于CK正常患者,糖尿病周围神经病变、糖尿病肾病和糖尿病视网膜病变发生率高于CK正常患者,CK水平在评估糖尿病酮症酸中毒患者临床结局中有一定的价值。Objective To investigate the value of creatine kinase(CK)in evaluating the clinical outcomes of patients with diabetic ketoacidosis.Methods Totally 40 diabetic patients were divided into study group with elevated CK level and control group with normal CK level,with 20 cases in each group.Fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),blood potassium,blood sodium,blood urea nitrogen(BUN),pH value,hemoglobin(Hb),bicarbonate(HCO 3-)and C peptide levels were detected and compared between the two groups.The condition of comorbidities was recorded in both groups.Results The levels of HbA1c,FBG and BUN in the study group were significantly higher than those in the control group,while the levels of pH value,Hb and HCO 3-were significantly lower than those in the control group(P<0.05).On admission,the level of C peptide in the study group was significantly lower than that in the control group(P<0.05).At 3 months after discharge,the level of C peptide in the study group was significantly higher than that on admission(P<0.05).The ratios of patients with diabetic peripheral neuropathy,diabetic nephropathy and diabetic retinopathy in the study group were significantly higher than those in the control group(P<0.05).Pearson correlation analysis showed that the level of CK was positively correlated with HbA1c level(r=0.336,P=0.012).Conclusion The levels of blood glucose in patients with diabetic ketoacidosis and elevated CK are significantly higher than those in patients with normal CK levels,while the incidence rates of diabetic peripheral neuropathy,diabetic nephropathy and diabetic retinopathy are higher than those in patients with normal CK.CK level shows a certain value in evaluating the clinical outcomes of patients with diabetic ketoacidosis.

关 键 词：糖尿病酮症酸中毒 肌酸激酶 电解质 血糖 合并症 

分 类 号：R587.2[医药卫生—内分泌]