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[糖尿病酮症酸中毒(病因、临床生化关联及术语问题)]

[Diabetic ketoacidosis (causes, clinico-biochemical correlations and terminology problems)].

作者信息

Blagosklonnaia Ia V, Berezko Iu N, Vershinin V N, Zalevskaia A G, Kudriashova M I

出版信息

Ter Arkh. 1984;56(10):94-7.

PMID:6441297
Abstract

The clinical and biochemical data obtained in 85 patients with diabetic ketoacidosis (DKA) are presented. DKA is an acute exacerbation of diabetes, a characteristic clinico-biochemical syndrome including increasing thirst, polyuria, adynamia, dryness of the skin and mucous membranes, anorexia, nausea, vomiting, occasionally abdominal pain, Kussmaul's breath, acetone odour in the exhaled air, circulatory collapse, prerenal azotemia, stupor, coma. Glycemia level exceeds 19 mmol/l, blood pH over 7.3. The disease is marked by neutrophilic leukocytosis, blood count shift to the left, elevated blood content of creatinine and urea. It was established that the degree of consciousness abnormality does not always correlate with the degree of the clinico-biochemical manifestations of DKA. During DKA, coma occurs relatively seldom (5.9%). It is suggested to use the term "diabetic ketoacidosis", incipient or marked, indicating the degree of consciousness abnormality (stupor, coma).

摘要

本文呈现了85例糖尿病酮症酸中毒(DKA)患者的临床和生化数据。DKA是糖尿病的急性加重期,是一种典型的临床生化综合征,包括口渴加剧、多尿、乏力、皮肤和黏膜干燥、厌食、恶心、呕吐,偶尔伴有腹痛、库斯莫尔呼吸、呼出气体中有丙酮气味、循环衰竭、肾前性氮质血症、昏睡、昏迷。血糖水平超过19 mmol/L,血液pH值低于7.3。该疾病的特征为中性粒细胞增多、血细胞计数左移、血液中肌酐和尿素含量升高。研究发现,意识异常程度并不总是与DKA的临床生化表现程度相关。在DKA期间,昏迷相对少见(5.9%)。建议使用“早期或明显糖尿病酮症酸中毒”这一术语,以表明意识异常程度(昏睡、昏迷)。

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