Clinical, hormonal, and biochemical characteristics of 70 chinese children with moderate to severe type 1 diabetic ketoacidosis.
Clinical, hormonal, and biochemical characteristics of 70 chinese children with moderate to severe type 1 diabetic ketoacidosis.
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70例中国中重度1型糖尿病酮症酸中毒儿童的临床、激素和生化特征
DOI：
10.1186/s12902-022-01227-9
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发表时间：
2022-12-02
影响因子：
2.7
通讯作者：
Li, Pin
中科院分区：
文献类型：
--
作者：
Liu, Qingxu;Yin, Xiaoqin;Li, Pin
糖尿病酮症酸中毒（DKA）是1型糖尿病（T1DM）最严重的急性并发症之一。不同严重程度的DKA患者的临床表现、血清生化水平及激素变化可能不同。对2015年至2020年上海儿童医院收治的70例中重度1型糖尿病酮症酸中毒患者在急性期和恢复期的血生化水平进行分析。37例重度DKA较33例中度DKA延长5.9h（P< 0.001）。此外，血清离子钙（P= 0.003）、游离三碘甲状腺原氨酸（FT 3）（P= 0.029）、白色细胞（WBC）（P= 0.044）和甘油三酯（TG）（P= 0.002）的血清水平在中度和重度DKA患者之间存在显著差异。重度DKA恢复后，血清离子钙水平显著降低。1周内，甲状腺激素和血脂水平恢复至正常范围，无需干预。结论重度DKA患者较中度DKA患者酸中毒纠正时间长，WBC计数、TG和离子钙水平高，FT3水平低。无需对甲状腺激素进行额外干预，血脂和血清离子钙水平恢复至正常范围。
BackgroundDiabetic ketoacidosis (DKA) is one of the most severe acute complications of type 1 diabetes mellitus (T1DM). Patients with DKA of different severities may have different clinical manifestations, serum biochemical levels and hormone changes.MethodsWe retrospectively evaluated the clinical manifestations, serum hormone levels, and biochemical levels of 70 Chinese patients with moderate to severe type 1 DKA in the acute and recovery phases admitted to Shanghai Children’s Hospital from 2015 to 2020.ResultsThe time required for acidosis correction in 37 patients with severe DKA was 5.9 h longer than that in 33 patients with moderate DKA (P< 0.001). In addition, serum levels of serum ionized calcium (P= 0.003), free triiodothyronine (FT3) (P= 0.029), white blood cells (WBCs) (P= 0.044), and triglycerides (TGs) (P= 0.002) were significantly different between patients with moderate and severe DKA. Serum levels of ionized calcium decreased significantly after recovery from severe DKA. Within 1 week, thyroid hormone and blood lipid levels recovered to normal ranges without intervention.ConclusionPatients with severe DKA had higher acidosis correction times, higher WBC counts, TGs and ionized calcium levels, and lower FT3 levels than patients with moderate DKA. No additional intervention was required for thyroid hormone, and blood lipid and serum ionized calcium levels recovered to the normal range.
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