以酮症酸中毒起病的初发糖尿病临床特点分析

目的：观察以酮症酸中毒起病的初发糖尿病的临床特点。方法选择2010年7月份至2013年12月份在我院治疗的糖尿病酮症酸中毒（ DKA）患者102例，根据患者发病前是否患有糖尿病分为两组，一组为DKA1组（以酮症酸中毒起病，发病前无糖尿病病史）共42例，一组为DKA2组（发病前已确诊有糖尿病）共60例。比较两组患者发病诱因、糖尿病分型特点及误诊率、治愈率、死亡率，并作出分析。结果 DKA1组起病时无明显诱因占42．8％明显高于DKA2组8．3％，差异有统计学意义（P＜0．05），有明确诱因中感染因素占38．1％；DKA 1组与DKA 2组的糖尿病类型分布不同，差异有统计学意义（P＜0．01），其中DKA 1组1型糖尿病、未分型糖尿病所占比例高于DKA 2组，2型糖尿病所占比例小于DKA 2组，差异有统计学意义（P＜0．05），DKA 1组误诊率高于DKA2组差异有统计学意义（P＜0．01）。结论以酮症酸中毒起病的初发糖尿病发病前多无明显诱因，容易误诊，应加强糖尿病及并发症的健康教育，及时监测，尽早进行干预和治疗。

Analysis of clinical characteristics of diabetes caused by ketoacidosis

Objective To study clinical characteristics of diabetes caused by ketoacidosis.Methods 102 patients with diabetes caused by ketoacidosis in our hospital from Jun 2010 to Dec 2013 were divided into two groups based on whether they were diagnosed with diabetes before suffering ketoacidosis.The DKA1 group has 42 patients ( whose diabetes was caused by ketoacidosis and had no di-abetes history previously) ,while the DKA2 group has 60 patients ( who were diagnosed with diabetes before suffering ketoacidosis) .Ill-ness inducement,diabetes types,misdiagnosis rate,recovery rate,death rate of two groups were compared and analyzed.Results The percentage in DKA1 group(42.8%),who had caught diabetes without obvious illness inducement,is significantly greater than DKA2 group( 8.3%)(P<0.05),and the percentage caused by infection,who had obvious illness inducement,is 38.1%.The type distribu-tions of the diabetes in these two groups are different and statiscally significant (P<0.01),wherein the percentages of the type I diabe-tes and the unclassified type diabetes in DKA1 group are greater than DKA2,while the percentage of the type II diabetes in DKA1 is less than DKA2,and the difference is statiscally significant (P<0.05).Meanwhile,the misdiagnosis rate in DKA1 is higher than DKA2,and the difference is statiscally significant (P<0.05).Conclusion Most of the diabetes caused by ketoacidosis has no obvi-ous illness inducement before suffering this disease,which were misdiagnosed easily.Accordingly,health education for diabetes and syn-drome should be strengthened,the in-time monitoring is necessary,and interference and therapy must be performed as early as possible.