本文選題：暴發(fā)性1型糖尿病 + 實(shí)驗(yàn)室指標(biāo)��； 參考：《廣西醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的：調(diào)查新診斷標(biāo)準(zhǔn)下以DKA起病的暴發(fā)性1型糖尿病的患病狀況并探討其實(shí)驗(yàn)室指標(biāo)特點(diǎn)。方法：1.回顧性分析廣西醫(yī)科大學(xué)第九附屬醫(yī)院2003年1月至2013年12月收治的238例糖尿病酮癥酸中毒住院患者(含重復(fù)住院患者)情況,按2012年日本Imagawa提出的診斷標(biāo)準(zhǔn),篩選出酮癥酸中毒起病的暴發(fā)性1型糖尿病(Fulminant Type 1 Diabetes Mellitus, FT1DM)患者；并結(jié)合182例發(fā)表在國(guó)內(nèi)文獻(xiàn)上DKA起病的FTIDM病例,分析DKA起病的FTIDM的流行病學(xué)特點(diǎn)。2.本院7例DKA起病的FTIDM患者,結(jié)合國(guó)內(nèi)報(bào)道的18例患者,對(duì)DKA起病的FTIDM患者的實(shí)驗(yàn)室指標(biāo)進(jìn)行分析。3.從上述238例DKA患者中篩選出DKA起病的T2DM為A組(34例),DKA起病的T1DM(非暴發(fā)性T1DM)為B組(34例),上述DKA起病的FT1DM為C組(25例),比較三組間實(shí)驗(yàn)室指標(biāo)。分別從A組和B組中篩選出病程在三月以內(nèi)的病例為A1組(33例)和B1組(32例),與C組的實(shí)驗(yàn)室指標(biāo)進(jìn)行比較分析。再分別從A1組和B1組中篩選出病程在一周以內(nèi)的病例為A2組(22例)和B2組(19例),與C組的實(shí)驗(yàn)室指標(biāo)進(jìn)行比較分析。結(jié)果：①238例糖尿病酮癥酸中毒患者中,T1DM99例(其中FTIDM 7例),95例患者以酮癥酸中毒為其糖尿病就診的初發(fā)表現(xiàn)(其中T1DM47例)。7例FT1DM占連續(xù)住院DKA病例的2.9%(7/238),占TlDM所致DKA的7.1%(7/99)；占DKA起病的新診斷糖尿病病例的7.4%(7/95),占DKA起病T1DM病例的14.9%(7/47)。截止至2013年,國(guó)內(nèi)報(bào)道189例DKA起病的FT1DM中,南方146例,北方43例,年齡最大為71歲,年齡最小為2歲。②25例DKA起病的FT1DM患者：男性10例,女性15例；南方19例,北方6例；妊娠相關(guān)8例；≤30歲11例,30歲14例。男性和女性、南方和北方、妊娠相關(guān)和非妊娠相關(guān)、≤30歲和30歲患者的血糖、HbAlc、血鈉、血鉀、血pH值比較差異均無(wú)統(tǒng)計(jì)學(xué)意義。③C組起病時(shí)的血糖、血鉀顯著高于A組、B組、A1組、B1組、A2組、B2組,而HbAl c則顯著低于A組、B組、A1組、B1組、A2組、B2組；C組起病時(shí)的血鈉、血pH值顯著低于A組、A1組,B組的血鈉顯著低于A組,其余的比較沒(méi)有統(tǒng)計(jì)學(xué)意義。結(jié)論：1以DKA起病的FT1DM發(fā)病為散發(fā),在DKA起病糖尿病患者中占有一定比例。2.以DKA起病的FTIDM患者起病時(shí)HbA1c小于8.7%的同時(shí),呈現(xiàn)高血糖、低血鈉、高血鉀、低pH值的特點(diǎn)。3.DKA起病的FTIDM患者起病時(shí)血糖、血鉀比DKA起病的非暴發(fā)性TIDM、DKA起病的T2DM的高,而其HbA1c比DKA起病的非暴發(fā)性TIDM、DKA起病的T2DM的低,病程會(huì)對(duì)比較的結(jié)果產(chǎn)生影響。
[Abstract]:Objective: to investigate the prevalence of fulminant type 1 diabetes mellitus (TDM) with DKA onset under the new diagnostic criteria and to explore its laboratory characteristics. Method 1: 1. A retrospective analysis of 238 cases of diabetic ketoacidosis (including repeated inpatients) admitted from January 2003 to December 2013 in the Ninth affiliated Hospital of Guangxi Medical University was carried out. Patients with fulminant Type 1 Diabetes Mellitus (FT1DM) with ketoacidosis were selected, and the epidemiological characteristics of FTIDM from DKA were analyzed. The laboratory indexes of 7 FTIDM patients with DKA onset and 18 reported FTIDM patients with DKA were analyzed. From the above 238 cases of DKA, 34 cases of T2DM with DKA onset were selected as group A and 34 cases with non-fulminant T1DM as group B, and 25 cases with FT1DM of group C with the above mentioned DKA. The laboratory indexes were compared among the three groups. 33 cases of group A1 and 32 cases of group B1 were selected from group A and group B within three months. The laboratory indexes of group A and group C were compared and analyzed. 22 cases in group A 2 and 19 cases in group B 2 were selected from group A1 and group B1, respectively. The laboratory indexes of group A 1 and group B 1 were compared with those of group C. Results among 1238 cases of diabetic ketoacidosis, 99 cases of T1DM (including 7 cases of FTIDM and 95 cases of ketoacidosis) were treated with ketoacidosis as the initial manifestation of diabetes mellitus (among them, T1DM47 cases accounted for 2.7% of DKA cases, accounting for 2.9% of TlDM cases, accounting for DKA caused by TlDM). The ratio of 7.1% to 7 / 99%; 7 / 95% of the newly diagnosed diabetes cases in DKA, and 14. 9% of 7 / 47% of the cases of DKA onset T1DM. Up to 2013, there were 146 cases of FT1DM in the south, 43 cases in the north, and the maximum age was 71 years old, and the youngest was 2 years old. 225 cases of FT1DM patients with onset of DKA were 10 males, 15 females, 19 patients from the south, 6 patients from the north, and 14 cases from the south, 6 cases from the north, 10 cases from the male to 15 cases from the female, 19 cases from the south and 6 cases from the north. Pregnancy related in 8 cases, 鈮，

本文編號(hào)：1811806