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

【摘要】：目的：對比研究快速血酮（末梢血β-羥丁酸）測定和尿酮體測定對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,同時篩選健康體檢者100例做為參照組。檢測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，并對所測得結果進行比較分析。并且檢測DKA組在經(jīng)過補液、調(diào)糖、對癥治療前后末梢血β-HBA、FBG及尿酮體數(shù)值，并對結果進行比較分析。 結果：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)計學意義； 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、尿酮體檢測水平也明顯高于其他兩組，P 0.01，差異有統(tǒng)計學意義；健康對照組中尿酮體出現(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性(分別為r=0.608,P0.01)。結論：1、NDK組中末梢血β－羥丁酸檢測陽性例數(shù)高于尿酮體陽性例數(shù)，末梢血β－HBA測定可早期發(fā)現(xiàn)其升高趨勢，對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、尿酮體檢測水平明顯高于其他兩組，末梢血β－羥丁酸檢測比尿酮體檢測準確度好。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可較準確地評價治療效果。4、末梢血β-羥丁酸濃度與血糖濃度成顯著正相關，臨床上可聯(lián)合檢測血糖，能夠較好的控制病情進展。
[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.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R587.2

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