酮症酸中毒起病的糖尿病患者的实验室指标比较

目的 提高临床医师对糖尿病酮症酸中毒(DKA)起病的暴发性1型糖尿病(FT1DM)的认识。方法 93例DKA起病的糖尿病患者根据糖尿病分型分为3组: 2型糖尿病（A）组、非暴发性1型糖尿病（B）组、FT1DM（C）组，对3组年龄、血糖、血钠、血钾、糖化血红蛋白、血pH值进行比较。结果 与2型糖尿病组相比，FT1DM组的血糖、血钾更高，HbA1c、血钠、血pH值更低，随着病程缩短，血pH值的比较无统计学意义。与非暴发性1型糖尿病组相比，FT1DM组的血糖、血钾更高，HbA1c更低，在血钠和血pH值的比较差异无统计学意义。结论 DKA起病的FT1DM患者具有更高的血糖和血钾，注意重视。除糖尿病类型外，糖尿病病程也影响酸中毒的实验室指标。

Comparative research of laboratory data in ketoacidosis onset diabetes patients

Objective To better understand the ketoacidosis onset fulminant type 1 diabetes（FT1DM）patients. Methods A total of 93 cases of ketoacidosis onset patients were divided into three groups according to diabetes type， including group A: type 2 diabetes; group B: type 1 diabetes without fulminant type 1 diabetes; group C: fulminant type 1 diabetes（FT1DM）. Age， glucose， serum sodium， serum potassium， glycated hemoglobin and pH value were compared among groups. Results Compared with the type 2 diabetes， FT1DM showed high levels of glucose and serum potassium and low levels of glycated hemoglobin， serum sodium and arterial pH. There was no statistical significant difference in serum sodium， arterial pH with shorter diabetic course. Compared with the group B， FT1DM showed higher level of glucose， serum potassium and lower levels of glycated hemoglobin. There was no statistical significant difference in serum sodium and arterial pH. Conclusion The ketoacidosis onset fulminant type 1 diabetes patients should be given more attention as they shared higher level of serum glucose and potassium. Not only the diabetes types， the time span from the onset of hyperglycemic symptoms to the ketoacidosis may affect the the laboratory data.