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2 型糖尿病急性胰腺炎患者发生糖尿病酮症酸中毒的危险因素。

Risk factors for diabetic ketoacidosis in acute pancreatitis patients with type 2 diabetes.

机构信息

Departments of Gastroenterology, First Affiliated Hospital of Wannan Medical College, 241001, Wuhu, Anhui Province, P. R. China.

出版信息

BMC Gastroenterol. 2023 Jul 27;23(1):257. doi: 10.1186/s12876-023-02869-2.

Abstract

BACKGROUND AND PURPOSE

In cinical, some acute pancreatitis patients with diabetes may have diabetic ketoacidosis (DKA). However, the risk factors for DKA in these patients remain unclear. The purpose of this study is to analyze the risk factors for DKA in acute pancreatitis patients with type 2 diabetes.

PATIENTS AND METHODS

Twenty-five patients were included in this prospective single-centre study to analyze the incidence and risk factors for DKA in acute pancreatitis patients with type 2 diabetes.

RESULTS

Seven of the twenty-five patients (28%) developed DKA within 48 h of admission. According to whether they had DKA, the twenty-five AP patients were divided into DKA group and non-DKA group. There were significant differences in age (P = 0.014), BMI (P = 0.034), poor previous blood glucose control (P < 0.001) and uric acid concentration (P = 0.041), but no statistically significant differences in sex (P = 0.597), number of drinkers (P = 0.407), number of smokers (P = 1.000), triglyceride level (P = 0.389) and total cholesterol concentration (P = 0.534) between the two groups. In both groups, 1 patients had severe pancreatitis, and the difference was no statistically significant (P = 0.490).

CONCLUSIONS

The incidence of DKA in AP patients with diabetes is high. Age, BMI, worse glycemic control and uric acid concentration may be predictors of DKA in AP patients with diabetes.

摘要

背景与目的

临床上,部分合并糖尿病的急性胰腺炎患者可能会出现糖尿病酮症酸中毒(DKA)。然而,此类患者发生 DKA 的危险因素仍不清楚。本研究旨在分析 2 型糖尿病合并急性胰腺炎患者发生 DKA 的危险因素。

患者与方法

本前瞻性单中心研究纳入 25 例患者,分析 2 型糖尿病合并急性胰腺炎患者中 DKA 的发生率及危险因素。

结果

25 例患者中,有 7 例(28%)在入院后 48 h 内发生 DKA。根据是否发生 DKA,将 25 例 AP 患者分为 DKA 组和非 DKA 组。两组间在年龄(P = 0.014)、BMI(P = 0.034)、既往血糖控制差(P < 0.001)和尿酸浓度(P = 0.041)方面差异有统计学意义,而在性别(P = 0.597)、饮酒人数(P = 0.407)、吸烟人数(P = 1.000)、甘油三酯水平(P = 0.389)和总胆固醇浓度(P = 0.534)方面差异无统计学意义。两组均有 1 例患者为重症胰腺炎,差异无统计学意义(P = 0.490)。

结论

糖尿病合并急性胰腺炎患者中 DKA 的发生率较高。年龄、BMI、血糖控制较差和尿酸浓度可能是糖尿病合并急性胰腺炎患者发生 DKA 的预测因素。

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Acute Pancreatitis: Diagnosis and Treatment.急性胰腺炎:诊断与治疗。
Drugs. 2022 Aug;82(12):1251-1276. doi: 10.1007/s40265-022-01766-4. Epub 2022 Sep 8.
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Diabetic ketoacidosis.糖尿病酮症酸中毒。
Nat Rev Dis Primers. 2020 May 14;6(1):40. doi: 10.1038/s41572-020-0165-1.
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Worldwide Variations in Demographics, Management, and Outcomes of Acute Pancreatitis.全球急性胰腺炎的人口统计学、治疗管理和结局差异。
Clin Gastroenterol Hepatol. 2020 Jun;18(7):1567-1575.e2. doi: 10.1016/j.cgh.2019.11.017. Epub 2019 Nov 9.
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Defining and characterising diabetic ketoacidosis in adults.成人糖尿病酮症酸中毒的定义和特征。
Diabetes Res Clin Pract. 2019 Sep;155:107797. doi: 10.1016/j.diabres.2019.107797. Epub 2019 Jul 22.

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