目的 探讨血清β-羟丁酸测定在糖尿病酮症酸中毒(DKA)和妊娠剧吐中的诊断价值.方法 采用酶速率法测定血清β-羟丁酸浓度,对糖尿病酮症酸中毒、糖尿病无酮症(NDK)、健康对照、妊娠剧吐孕妇、正常孕妇组进行β-羟丁酸检测,同时对其进行尿酮体和血糖检验.结果 DKA的β-羟丁酸浓度和阳性率显著高于NDK组(P＜0.01)和对照组(P＜0.01);NDK组的β-羟丁酸浓度与对照组比较差异有统计学意义(P＜0.05);DKA尿酮体阳性率显著高于NDK组(P＜0.01)和对照组(P＜0.01).妊娠剧吐组的β-羟丁酸浓度和阳性率显著高于正常孕妇组(P＜0.01);妊娠剧吐组的尿酮体阳性率显著高于正常孕妇组(P＜0.01).结论 β-羟丁酸对DKA和妊娠剧吐的早期诊断具有重要的诊断价值,对鉴别诊断和治疗的疗效观察具有重要意义,联合血糖、尿酮体等同时检测更能全面诊断和分析疾病.%Objective To investigate the clinical diagnostic value of serum (3-hydroxybutyrate in diabetic ketoacidosis (DKA) and hyperemesis gravidarum. Methods Knzyme rate method was used to measure serum (3-hydroxybutyrate concentration in subjects of DKA group, non-ketotic diabetic (NDK) group, healthy controls (healthy group) , pregnant women with hyperemesis gravidarum group and healthy pregnant women group,and the levels of urine ketone bodies and blood glucose were also detected. Results (3-hydroxybutyrate concentration and positive rate of DKA group were significantly higher than NDK group (P<0. 01) and healthy group (P<0. 01); there was statistical difference between NDK group and healthy group (P<0. 05); the positive rate of DKA group was significantly higher than NDK group (P <0. 01) and the healthy group(P<0. 01). (3-hydroxybutyrate concentration and positive rate of pregnant women with hyperemesis gravidarum group was significantly higher than healthy pregnant women group (P<0. 01); ketone-positive rate of pregnant women with hyperemesis gravidarum group was significantly higher than healthy pregnant women group (P<0. 01). Conclusion (3-hydroxybutyrate level might have significant clinical value for the early diagnosis of DKA and hyperemesis gravidarum, with important significance in differential diagnosis and treatment efficacy evaluation, and should be more comprehensive to diagnose and analyze the disease, when combined with blood glucose and urine ketone bodies.
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