糖尿病患者发生酮体蓄积的预测

摘要

Objective To investigate the primary risk factors and cutpoints for ketone body accumulation in diabetic patients without therapy suspending. Methods A total of 753 diabetic patients were divided into ketone group(67 cases) and non-ketone group(686 cases). The relationship between study factors,such as sex, body weight, blood glucose, body mass index, C-peptide, types of diabetes and glycosylated hemoglobin A1c(HbA1c), and ketone body accumulation was analyzed by multivariate logistic regression and the cutpoints were detected by ROC curve. Results HbA1c was the most important risk factor for ketone body accumulation(OR＞ 1, P＜0. 05). The cutpoint of HbAlc for prediction of ketone body accumulation was 8.9％. Conclusion Diabetic patients with high HbAlc(＞8. 9 ％ ) should undergo screening test to exclude diabetic ketosis or diabetic ketoacidosis.%目的 探讨治疗无中断的糖尿病患者发生酮体蓄积的关键预测因子及其预测值.方法 753例糖尿病住院患者分为酮体蓄积组(67例)和无酮体蓄积组(686例).比较两组患者年龄、性别、体重指数、血糖、糖化血红蛋白、血清C肽、糖尿病类型及合并感染的比例,采用Logistic回归分析糖尿病患者发生酮体蓄积的相关因素.结果 糖化血红蛋白是预警糖尿病患者发生酮体蓄积的关键危险因素,其预测的适宜切割点为8.9%.敏感性为87.5%,特异性为62.9%.结论 糖尿病患者一旦糖化血红蛋白超过8.9%,应监测酮体以及早诊断有无酮症或酮症酸中毒.