AMS、BUN及β-HB在糖尿病酮症酸中毒诊断及病情评估中的作用  

The role of blood amylase,BUN andβ⁃HB in the diagnosis and evaluation of diabetic ketoacidosis

作　　者：张建丽 李丽花 朱丽丽 ZHANG Jiani;LI Lihua;ZHU Lii(Department of Emergency Internal Medicine,Taiyuan Eighth Peoples Hospital,Taiyuan,Shanxi,China,030300;Department of Endocrinology,Taiyuan Eighth Peoples Hospital,Taiyuan,Shanxi,China,030300)

机构地区：[1]太原市第八人民医院急诊内科,山西太原030300 [2]太原市第八人民医院内分泌科,山西太原030300

出　　处：《分子诊断与治疗杂志》2023年第11期2008-2011,2015,共5页Journal of Molecular Diagnostics and Therapy

基　　金：山西省基础研究计划项目(202103021224373)。

摘　　要：目的 分析血淀粉酶(AMS)、血尿氮素(BUN)及β-羟丁酸(β-HB)在糖尿病酮症酸中毒(DKA)诊断及病情评估中的作用。方法 选取2020年1月至2022年6月太原市第八人民医院收治的DKA患者205例(DKA组)、无DKA的糖尿病患者100例(无DKA组),选取同期进行健康体检者80名为对照组。比较三组研究对象一般资料以及AMS、BUN、β-HB水平;比较DKA患者不同病情程度AMS、BUN、β-HB水平;采用Logistic回归分析影响DKA发生的危险因素;绘制ROC曲线分析AMS、BUN、β-HB单独及联合诊断DKA的价值。结果 三组年龄、性别、BMI比较,差异无统计学意义(P>0.05);AMS水平:DKA组>无DKA组>对照组,BUN水平:DKA组>无DKA组>对照组,β-HB水平:DKA组>无DKA组>对照组,差异均有统计学意义(P<0.05);AMS水平:重度>中度>轻度,BUN水平:重度>中度>轻度,β-HB水平:重度>中度>轻度,差异均有统计学意义(P<0.05);经Logistic回归分析,AMS>220 U/L、BUN>7.1 mmol/L、β-HB>0.263 mmol/L均是DKA发生的危险因素(P<0.05);AMS、BUN、β-HB三者联合诊断DKA的AUC为0.821,高于AMS、BUN、β-HB单独检测(P<0.05)。结论 DKA患者AMS、BUN、β-HB升高,三指标与患者病情严重程度有关,有望成为诊断DKA的标志物,为临床诊治DKA提供重要参考信息。Objective To analyze the effects of blood amylase(AMS),blood urea nitrogen(BUN)andβ-hydroxybutyric acid(β-HB)on the diagnosis and evaluation of diabetic ketoacidosis(DKA).Methods 205 cases of DKA patients(DKA group)and 100 cases of diabetic patients without DKA(non-DKA group)admitted to our hospital from January 2020 to June 2022 were selected,and 80 cases of healthy people who underwent physical examination in the same period were selected as the control group.The general information and the levels of AMS,BUN andβ-HB of the three groups of research subjects were compared;the levels of AMS,BUN andβ-HB were compared in different degrees of DKA patients.The risk factors affecting the occurrence of DKA were analyzed by logistic regression.The ROC curves were drawn to analyze the value of AMS,BUN,β-HB alone and in combination in diagnosing DKA.Results There was no significant difference in age,sex and BMI among the three groups(P>0.05).The AMS level:DKA group>no DKA group>control group,the BUN level:DKA group>no DKA group>control group,theβ-HB level:DKA group>no DKA group>control group,the difference was statistically significant(P<0.05).AMS level:severe>moderate>mild,BUN level:severe>moderate>mild,β-HB level:severe>moderate>mild,the difference was statistically significant(P<0.05).According to logistic regression analysis,AMS>220 U/L,BUN>7.1 mmol/L,β-HB>0.263 mmol/L were all risk factors for DKA,and the difference was statistically significant(P<0.05).The AUC of AMS,BUN andβ-HB for the combined diagnosis of DKA was 0.821,which was higher than AMS,BUN,β-HB were detected separately.Conclusion The increase of AMS,BUN andβ-HB in DKA patients is related to the severity of the disease,and it is expected to become a marker for the diagnosis of DKA,providing important reference information for the clinical diagnosis and treatment of DKA.

关 键 词：血淀粉酶 血尿氮素 Β-羟丁酸 糖尿病酮症酸中毒 

分 类 号：R587.2[医药卫生—内分泌]