急性胰腺炎合并糖尿病酮症酸中毒：来自中国南方的队列研究。
Acute pancreatitis concomitant with diabetic ketoacidosis: a cohort from South China.
机构信息
Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
Department of Emergency Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
出版信息
J Int Med Res. 2020 Mar;48(3):300060520912128. doi: 10.1177/0300060520912128.
OBJECTIVE
To evaluate the clinical characteristics of acute pancreatitis (AP) concomitant with diabetic ketoacidosis (DKA) in a cohort from South China and identify factors associated with early detection of DKA in AP patients.
METHODS
Inpatient medical records of AP concomitant with DKA were retrospectively reviewed.
RESULTS
Forty-eight patients with AP concomitant with DKA were enrolled in this study. The results indicated that comorbidity history of diabetes mellitus and mental status of not alert on admission were factors associated with DKA in AP patients. Compared with patients without DKA, patients with DKA showed significantly higher rates of hypertriglyceridemia and lower rates of gallstones than those without DKA. AP patients with concurrent DKA had higher levels of serum triglycerides, longer lengths of hospital stays, and higher complication rates of systemic inflammatory response syndrome and acute kidney injury.
CONCLUSION
AP patients might have higher risks of concomitant DKA if presenting as not alert upon admission or if they have past medical histories of diabetes mellitus. Serum triglyceride levels were significantly higher in AP patients with DKA. DKA raised the severity of AP, but did not increase in-hospital mortality.
目的
评估华南地区急性胰腺炎（AP）合并糖尿病酮症酸中毒（DKA）患者的临床特征，并确定与 AP 患者 DKA 早期发现相关的因素。
方法
回顾性分析 AP 合并 DKA 的住院患者病历。
结果
本研究共纳入 48 例 AP 合并 DKA 患者。结果表明，糖尿病合并症病史和入院时意识状态不警觉是 AP 患者发生 DKA 的相关因素。与无 DKA 的患者相比，有 DKA 的患者中高脂血症的发生率更高，而胆囊结石的发生率更低。并发 DKA 的 AP 患者的血清甘油三酯水平更高，住院时间更长，全身炎症反应综合征和急性肾损伤的并发症发生率更高。
结论
入院时意识状态不警觉或有糖尿病病史的 AP 患者可能有更高的并发 DKA 的风险。合并 DKA 的 AP 患者的血清甘油三酯水平显著升高。DKA 加重了 AP 的严重程度，但并未增加住院死亡率。
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