糖尿病酮症酸中毒患者血清中炎性细胞因子水平增高的临床意义

目的探讨糖尿病酮症酸中毒患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平变化与病情加重的关系。方法选取46例糖尿病酮症酸中毒患者,其中合并感染者28例,非感染者18例,同时选取同期非酮症糖尿病患者32例作为对照组。留取清晨空腹静脉血,检查血常规同时检测各组患者空腹血糖(FPG)、糖化血红蛋白(Hb A1c)生化指标的变化情况;收集患者尿液检测尿酮体变化;ELISA法检测血清IL-6,TNF-α,CRP水平。结果 DKA感染组和非感染组血清IL-6、TNF-α、CRP水平均明显高于对照组,差异具有统计学意义(均P<0.05)。与DKA非感染组相比,DKA感染组IL-6、TNF-α、CRP水平也有明显升高,差异也具有统计学意义(P<0.05)。DKA合并感染患者空腹血糖与IL-6、TNF-α、CRP均成正相关(r分别为0.534、0.652、0.493,均P<0.01),而DKA合并感染患者CRP与IL-6、TNF-α亦成正相关(r分别为0.678、0.624,均P<0.01)。结论糖尿病酮症酸中毒患者的血清IL-6、TNF-α、CRP水平变化明显升高,与疾病严重程度有一定的关系。

The Clinical Significance of the Inflammatory Cytokines Levels Increasing in Serum of Patients with Diabetic Ketoacidosis

Objective To investigate the relationship between the changes of serum interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α） and C-reactive protein （CRP） levels and exacerbations in patients with diabetes ketoacidosis. Methods 46 patients with diabetes ketoacidosis were recruited, of which 28 patients were infectious. Besides, 32 diabetic patients without diabetes ketoacidosis were enrolled as control at the same time. Routine blood test, Fasting blood glucose （FPG）, glycosylated hemoglobin （HbA1c） and urine acetone bodies were detected. Serum IL-6, TNF-α, and CRP was measured by ELISA kits. Results The levels of IL-6, TNF-α, CRP were significantly higher in both DKA groups than those of control group （P〈0.05）, and those indexes in infectious DKA group were also higher compared to non-infectious DKA group （P〈0.05）. According to the correlation analysis, there was a positive correlation of FPG, IL-6, TNF-α, CRP（r=0.534, 0.652, 0.493, all P〈0.01） in infectious DKA group. Meanwhile, CRP had a correlation with IL-6 and TNF-α in infectious DKA group （r=0.678 and 0.624, respectively, all P〈0.01）. Conclusion An increase of CRP, IL-6 and CRP in DKA were detected in DKA patients, which reflected the severity of DKA to some extent.