糖尿病酮症酸中毒相关危险因素分析

目的：探讨糖尿病患者发生酮症酸中毒的相关危险因素。方法：对2006-07-2011-05我院急诊科收治的62例糖尿病酮症酸中毒患者的临床诊治资料进行回顾性研究;同时选取同期住院治疗的无酮症酸中毒的糖尿病患者72例作为对照组进行对比研究。纳入回顾性研究的因素包括：性别、年龄、感染史、饮食不当、治疗不当、肝肾功能异常、糖尿病病程、糖尿病健康教育经历。利用SPSS13.0软件对所得计数资料进行χ2检验,计量资料进行独立样本t检验,同时为排除混杂因素的干扰进行多因素Logistic回归分析。结果：通过对计数资料进行χ2检验,计量资料进行独立样本t检验,得出年龄（P〈0.01）,感染史（P〈0.01）、治疗不当（P〈0.05）、糖尿病病程（P〈0.05）、糖尿病健康教育经历（P〈0.05）是糖尿病患者发生酮症酸中毒的相关危险因素。进行多因素Lo-gistic回归分析显示感染史（P〈0.01;OR=4.192）、治疗不当（P〈0.01;OR=3.719）为糖尿病酮症酸中毒独立危险因素,而年龄（P〈0.01;OR=0.299）、糖尿病健康教育经历（P〈0.05;OR=0.457）为保护因素。结论：感染史、治疗不当为糖尿病患者发生酮症酸中毒的独立危险因素,而糖尿病酮症酸中毒的发病率也随着年龄增大及糖尿病健康教育经历的越来越丰富有显著下降。

Analysis of risk factors for diabetic ketoacidosis

Objective：To investigate the risk factors of diabetic ketoacidosis.Method：Retrospectively analyzed the clinical data of 62 cases of diabetic ketoacidosis in the emergency department,and 72 cases of diabetic patient without ketoacidosis as the control group.Sex,age,infection history,improper diet,inappropriate treatment,hepatorenal dysfunction,course of diabetes and diabetes instruction were measured retrospectively.All the data was analyzed by spss 13.0 including chi-square test for counts material and independent sample T-test for measurement material.To exclude confounding factors,multivariat logistic regression analysis was performed.Result：Chi-square tests and independent sample T-tests showed that sex（P0.01）,infection history（P0.01）,inappropriate treatment（P0.05）,course of diabetes（P0.05）,diabetes instruction（P0.05） were influencing factors of diabetic ketoacidosis.However,multivariat logistic regression analysis revealed that infection history（P0.01;OR=4.192） and inappropriate treatment（P0.01;OR=3.719） were the independent risk factors for ketoacidosis in patients with diabetes,and sex（P0.01;OR=0.299）,diabetes instruction（P0.05;OR=0.457） were independent protection factors.Conclusion：Infection history and inappropriate treatment are the independent risk factors for diabetic ketoacidosis,and there will be a significant decrease in the incidence rate of diabetic ketoacidosis with increasing age and getting rich of diabetes instruction.