连续性血液净化对糖尿病乳酸酸中毒的治疗作用  

The therapeutic effect of continuous blood purification on diabetic lactic acidosis

作　　者：戴春芹 钱鹏[1] 姜道利 DAIChunqin;QIAN Peng;JIANG Daoli(Blood Purification Center,The Second Affiliated Hospital of Soochozw University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第二医院血液净化中心,215000 [2]徐州医科大学附属医院药学部

出　　处：《中国糖尿病杂志》2024年第1期37-41,共5页Chinese Journal of Diabetes

摘　　要：目的探讨连续性血液净化对糖尿病乳酸酸中毒(DLA)的治疗作用。方法选取2020年1月至2023年1月于我院血液净化中心治疗的DLA患者60例,随机分为常规治疗组(Con)和连续性血液净化组(CBP),每组各30例。比较两组阴离子间隙(AG)、pH、乳酸(Lac)、FPG、2 hPG、HbA_(1)c、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、血肌酐(Scr)、BUN、胱抑素C(CysC)、血钾(K^(+))、C-RP及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ),统计28 d死亡率。结果治疗48 h后,CBP组Lac清除率及p H值高于Con组,AG、Lac、FPG、2 hPG、HbA_(1)c、ALT、AST、TBIL、Scr、BUN、CysC、K^(+)、C-RP、APACHEⅡ评分及28 d死亡率低于Con组(P<0.05)。结论DLA患者常规治疗的同时应用连续性血液净化,可提升Lac清除率并改善预后。Objective To investigate the therapeutic effect of continuous blood purification on diabetic lactic acidosis(DLA).Methods 60 DLA patients who were treated at our hospital Blood Purification Center from January 2020 to January 2023 were randomly divided into conventional treatment group(Con)and continuous blood purification group(CBP),with 30 cases in each group.The changes of anion gap(AG),pH,lactic acid(Lac),FPG,2 h PG,HbA_(1)c,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),serum creatinine(Scr),urea nitrogen(BUN),cystatin C(CysC),blood potassium(K^(+)),C-reactive protein(C-RP),acute and chronic health evaluation scoring systemⅡ(APACHEⅡ)and mortality within 28 days were compared between the two groups.Results After 48 h of treatment,the clearance rate of Lac in CBP group was higher than that in Con group(P<0.05).The pH value of CBP group was higher than Con group.The levels of AG,Lac,FPG,2 hPG,HbA_(1)c,ALT,AST,TBIL,Scr,BUN,CysC,K^(+),C-RP and APACHEⅡscore were lower in CBP group than those in Con group(P<0.05).The 28-day mortality rate of the CBP group was lower than that of the Con group(P<0.05).Conclusion Continuous blood purification combined with routine treatment in DLA patients can increase Lac clearance and improve the prognosis.

关 键 词：糖尿病乳酸酸中毒 连续性血液净化 治疗作用 

分 类 号：R587.2[医药卫生—内分泌]