Huang Bin, Yang Shengju, Ye Shandong
Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, People's Republic of China.
Research Institution of Diabetes, University of Science and Technology of China, Hefei, People's Republic of China.
Diabetes Metab Syndr Obes. 2022 Jul 22;15:2127-2133. doi: 10.2147/DMSO.S371437. eCollection 2022.
Early detection of bacterial infections associated with adequate antibiotic treatment is key to improving diabetic ketoacidosis (DKA) outcomes. Our study aimed to investigate the different sepsis markers (including procalcitonin to lactic acid ratio, PLR) to diagnose bacterial infection in patients with DKA within one hour after admission.
A total of 165 patients diagnosed with DKA were enrolled between July 2014 and July 2018 and divided into an infection group (N =62) and a non-infection group (N=103) based on the positive aetiological tests such as blood culture, sputum culture, urine culture, or definite focus of pulmonary, soft tissue, kidney, etc.
Our findings suggest the following: 1) leucocytes (threshold above 10×10 /L) and PLR (threshold above 0.438) within one hour after admission can help to identify patients with infection in the context of DKA. 2) A subgroup analysis demonstrated that PLR also has a high diagnostic efficacy for infection in patients with DKA, regardless of the type of diabetes.
This study concludes that leucocyte count (threshold > 10×10/L) and PLR (threshold above 0.438) show a diagnostic value to help distinguish DKA patients with infection. By combining these two markers, the reduction of antibiotic misuse may be possible.
早期发现细菌感染并给予适当的抗生素治疗是改善糖尿病酮症酸中毒（DKA）预后的关键。我们的研究旨在调查不同的脓毒症标志物（包括降钙素原与乳酸比值，即PLR），以在入院后一小时内诊断DKA患者的细菌感染。
2014年7月至2018年7月期间，共纳入165例诊断为DKA的患者，并根据血培养、痰培养、尿培养等阳性病因学检查或肺部、软组织、肾脏等明确病灶，分为感染组（N = 62）和非感染组（N = 103）。
我们的研究结果表明：1）入院后一小时内的白细胞（阈值高于10×10⁹/L）和PLR（阈值高于0.438）有助于识别DKA背景下的感染患者。2）亚组分析表明，无论糖尿病类型如何，PLR对DKA患者的感染也具有较高的诊断效能。
本研究得出结论，白细胞计数（阈值> 10×10⁹/L）和PLR（阈值高于0.438）具有诊断价值，有助于区分有感染的DKA患者。通过结合这两种标志物，可能减少抗生素的滥用。
