本文關(guān)鍵詞： 糖尿病酮癥酸中毒 末梢血β－羥丁酸 尿酮體　出處：《吉林大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：對(duì)比研究快速血酮（末梢血β-羥丁酸）測(cè)定和尿酮體測(cè)定對(duì)糖尿病酮癥酸中毒的診斷及治療的臨床意義。 方法：在2012年1月到2013年12月期間，于入院的患者中，篩選糖尿病酮癥酸中毒患者（Diabetic ketoacidosis，DKA組）50例，糖尿病非酮癥組（Non-diabetic ketosis,NDK組）100例,同時(shí)篩選健康體檢者100例做為參照組。檢測(cè)以上三組人員末梢血β-羥丁酸(β-hydroxybutyricacid,β-HBA)、空腹血糖(Fasting plasma glucose, FPG)以及尿酮體，并對(duì)所測(cè)得結(jié)果進(jìn)行比較分析。并且檢測(cè)DKA組在經(jīng)過補(bǔ)液、調(diào)糖、對(duì)癥治療前后末梢血β-HBA、FBG及尿酮體數(shù)值，并對(duì)結(jié)果進(jìn)行比較分析。 結(jié)果：1、糖尿病非酮癥組中的血β-羥丁酸陽性例數(shù)較尿酮體陽性例數(shù)多，P 0.05，差異有統(tǒng)計(jì)學(xué)意義； DKA組與NDK組、健康組相比較，末梢血β-羥丁酸值明顯高于其他兩組,血糖值、尿酮體檢測(cè)水平也明顯高于其他兩組，P 0.01，差異有統(tǒng)計(jì)學(xué)意義；健康對(duì)照組中尿酮體出現(xiàn)2例的陽性。2、DKA組治療后末梢血β-羥丁酸值較治療前明顯降低，與治療前相比較，差異有顯著性意義(P 0.05)；治療后尿酮體陽性數(shù)5例。3、末梢血β-羥丁酸濃度與血糖濃度成顯著正相關(guān)性(分別為r=0.608,P0.01)。結(jié)論：1、NDK組中末梢血β－羥丁酸檢測(cè)陽性例數(shù)高于尿酮體陽性例數(shù)，末梢血β－HBA測(cè)定可早期發(fā)現(xiàn)其升高趨勢(shì)，對(duì)早期診斷有重要意義。2、DKA組較其他兩組，，末梢血β-HBA值、血糖值、尿酮體檢測(cè)水平明顯高于其他兩組，末梢血β－羥丁酸檢測(cè)比尿酮體檢測(cè)準(zhǔn)確度好。3、DKA組治療后較治療前，末梢血β-HBA值較治療前明顯降低，尿酮體陽性數(shù)5例，說明末梢血β-HBA可較準(zhǔn)確地評(píng)價(jià)治療效果。4、末梢血β-羥丁酸濃度與血糖濃度成顯著正相關(guān)，臨床上可聯(lián)合檢測(cè)血糖，能夠較好的控制病情進(jìn)展。
[Abstract]:Objective: to study the clinical significance of rapid determination of beta-hydroxybutyric acid (尾 -hydroxybutyric acid) in peripheral blood and determination of urinary ketone body in the diagnosis and treatment of diabetic ketoacidosis. Methods: from January 2012 to December 2013, 50 patients with diabetic ketoacidosis and 100 patients with non-diabetic ketoacidosis NDK were selected. The peripheral blood 尾 -hydroxybutyric acid (尾 -HBAd), fasting plasma glucose (FPGs) and urine ketone body were detected in the three groups, and the results were compared and analyzed. The peripheral blood 尾-HBA- FBG and urinary ketone body were compared before and after symptomatic treatment. Results the blood 尾 -hydroxybutyric acid (尾 -hydroxybutyric acid) positive rate in non-ketosis group was significantly higher than that in urine ketone body positive group (P 0.05), and the serum 尾 -hydroxybutyric acid (尾 -hydroxybutyric acid) level in DKA group was significantly higher than that in NDK group and healthy group (P 0.05), and the blood glucose level was significantly higher in DKA group than in other two groups. The level of urinary ketone body was also significantly higher than that of the other two groups (P 0.01), and the level of 尾 -hydroxybutyric acid (尾 -hydroxybutyric acid) in the peripheral blood of 2 cases with positive urethral ketone body appeared in the healthy control group after treatment was significantly lower than that before treatment, which was significantly lower than that before treatment. The positive number of urinary ketobutyric acid (尾 -hydroxybutyric acid) in peripheral blood was positively correlated with blood glucose concentration (r = 0.608) (P 0.01). Conclusion the detection of 尾 -hydroxybutyric acid in peripheral blood is higher than that in urine ketone body in the group of 0.608 渭 g / min ~ (-1) NDK (P < 0.05), and the positive rate of 尾 -hydroxybutyric acid in peripheral blood is higher than that in the group of urine ketone body (P < 0.05). The detection of 尾 -HBA in peripheral blood was significant for early diagnosis. The 尾 -HBA value, blood glucose and urine ketone body level in DKA group were significantly higher than those in the other two groups, and the level of 尾 -HBA in peripheral blood was significantly higher in DKA group than in the other two groups, and the level of 尾 -HBA in peripheral blood was significantly higher than that in other two groups. The accuracy of 尾 -hydroxybutyric acid detection in peripheral blood was better than that in urine ketone body detection. The 尾 -HBA value of peripheral blood in DKA group was significantly lower than that before treatment, and the positive rate of urinary ketone body was 5 cases in DKA group. The results showed that 尾 -HBA in peripheral blood could accurately evaluate the therapeutic effect. The concentration of 尾 -hydroxybutyric acid in peripheral blood was positively correlated with blood glucose concentration.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R587.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 朱建中,周衍;電化學(xué)生物傳感器的進(jìn)展[J];傳感器世界;1997年04期

2 簡(jiǎn)榮漢;蘇葵花;;老年人糖尿病酮癥酸中毒并高血糖高滲狀態(tài)21例[J];福建醫(yī)藥雜志;2012年03期

3 馬念章,李光,廖靜敏;人體內(nèi)酮體檢測(cè)技術(shù)的研究進(jìn)展[J];分析化學(xué);2005年07期

4 董振南;張丹;劉紅艷;李元光;孫曉亮;何偉;;手持式血酮體測(cè)試儀的臨床評(píng)價(jià)[J];分析儀器;2008年03期

5 朱延清;;血清β-羥丁酸在糖尿病酮癥酸中毒和妊娠劇吐中的診斷價(jià)值[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2012年04期

6 施耀方;鄒建英;;末梢血β-羥丁酸與尿酮體測(cè)定在糖尿病酮癥預(yù)后及診斷中的研究[J];護(hù)士進(jìn)修雜志;2012年22期

7 盧妙蓮;王建兵;曹永堅(jiān);萬澤民;程招敏;林莉;徐建華;;2種POCT血酮體儀與生化分析儀對(duì)β-羥丁酸檢測(cè)結(jié)果的比對(duì)分析[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2013年11期

8 劉夢(mèng)瓊 ,陳代釗 ,梁豐;血清D-3-羥基丁酸測(cè)定與傳統(tǒng)血酮體定性檢測(cè)比較分析[J];海南醫(yī)學(xué);2003年03期

9 張耀平,李皇;糖尿病酮癥酸中毒檢測(cè)血清β羥丁酸的重要意義[J];海南醫(yī)學(xué);2004年10期

10 張穎;于永光;王卓茹;邢燕;;乙酰乙酸/β-羥丁酸檢測(cè)用于早期糖尿病及糖尿病診斷的研究[J];哈爾濱醫(yī)科大學(xué)學(xué)報(bào);2008年05期

本文編號(hào)：1498393