School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China.
Int J Med Sci. 2013 Apr 18;10(6):758-65. doi: 10.7150/ijms.6155. Print 2013.
To determine the correlation between differential leukocyte counts and hyperglycemic emergencies.
Fifty patients with diabetic ketoacidosis (DKA), 50 patients with diabetic ketosis (DK), 50 non-DK diabetic patients with stable glycemic control, and 50 normal controls were enrolled. Their total and differential leukocyte counts were measured and evaluated at admission and after treatment.
The patients with DKA and DK had higher plasma glucose levels (20.84±6.73 mmol/L, 15.55±2.6 mmol/L, respectively) and more median leukocytes (13325/mm(3) and 6595/mm(3), respectively) and median neutrophils (11124 /mm(3) and 4125/mm(3), respectively) but fewer median eosinophils (28/mm(3) and 72/mm(3), respectively) compared to non-DK and control groups (all p < 0.05). Acute infection increased the elevating extent. The median leukocyte counts in DK and non-DK patients (6595/mm(3) and 6008/mm(3), respectively) were within the normal range. The counts of total leukocytes and neutrophils were significantly higher but eosinophils lower in severe DKA cases than in mild/moderate cases (p < 0.05). When the DKA and DK and infection resolved, total leukocytes and neutrophils fell, but eosinophils increased. The counts of total leukocytes, neutrophils, and monocytes were negatively correlated with arterial pH levels (r = -0.515, r = -0.510, r = -0.517, all p < 0.001, respectively) and positively correlated with plasma glucose levels (r = 0.722, r = 0.733, r = 0.632, all p < 0.05, respectively) in DKA patients. The arterial pH level was the most significant factor affecting total leukocytes in DKA (β = 0.467, p = 0.003). The diagnosis analysis showed that higher total leukocyte and neutrophil counts and lower eosinophil counts had a significant ability to reflect the presence of hyperglycemic emergencies.
More total leukocytes and neutrophils but fewer eosinophils was significantly correlated with DKA and DK. Leukocyte counts can add valuable information to reflect the presence of hyperglycemic crisis and acute infection.
确定白细胞分类计数与高血糖急症之间的相关性。
纳入 50 例糖尿病酮症酸中毒（DKA）患者、50 例糖尿病酮症（DK）患者、50 例血糖控制稳定的非 DK 糖尿病患者和 50 例正常对照者。分别于入院时和治疗后检测并评估其总白细胞计数和白细胞分类计数。
DKA 和 DK 患者的血浆葡萄糖水平较高（分别为 20.84±6.73mmol/L 和 15.55±2.6mmol/L），白细胞中位数[分别为 13325/mm³和 6595/mm³]和中性粒细胞中位数[分别为 11124/mm³和 4125/mm³]较高，而嗜酸性粒细胞中位数[分别为 28/mm³和 72/mm³]较低，与非 DK 组和对照组比较，差异均有统计学意义（均 P<0.05）。急性感染会增加这种升高程度。DK 和非 DK 患者的白细胞计数（分别为 6595/mm³和 6008/mm³）均在正常范围内。重度 DKA 患者的总白细胞计数和中性粒细胞计数明显高于轻度/中度 DKA 患者，而嗜酸性粒细胞计数则低于轻度/中度 DKA 患者（P<0.05）。当 DKA 和 DK 及感染得到控制后，总白细胞计数和中性粒细胞计数下降，但嗜酸性粒细胞计数增加。DKA 患者的总白细胞计数、中性粒细胞计数和单核细胞计数与动脉 pH 值呈负相关（r=-0.515、r=-0.510、r=-0.517，均 P<0.001），与血浆葡萄糖水平呈正相关（r=0.722、r=0.733、r=0.632，均 P<0.05）。动脉 pH 值是影响 DKA 患者总白细胞计数的最显著因素（β=0.467，P=0.003）。诊断分析表明，较高的总白细胞计数和中性粒细胞计数以及较低的嗜酸性粒细胞计数能够显著反映高血糖急症的存在。
DKA 和 DK 与更多的总白细胞计数和中性粒细胞计数以及更少的嗜酸性粒细胞计数显著相关。白细胞计数可以提供有价值的信息，反映高血糖危象和急性感染的存在。
