ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2022, Vol. 14 ›› Issue (3): 228-231.

• 临床研究 • 上一篇    下一篇

糖尿病酮症酸中毒患儿病情严重程度的危险因素分析

  

  • 出版日期:2022-06-25 上线日期:2023-12-01

Analysis of risk factors for severity of diabetic ketoacidosis in children

  • Published:2022-06-25 Online:2023-12-01

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摘要： 目的 探讨糖尿病酮症酸中毒(DKA)患儿疾病严重程度的危险因素。方法 回顾性分析2017年10月～2020年10月在本院收治的DKA患儿60例，按疾病严重程度将患儿分为轻度组和中重度组各30例。对患儿的一般资料、临床资料、生活习惯、治疗方式、入院时实验室检查结果等方面进行统计，并采用χ2检验分析计数资料，独立样本t检验分析计量资料，同时进行Logistic回归分析，以确定影响患儿DKA严重程度的相关危险因素，探讨有效科学的防治对策。结果 单因素分析结果显示，中重度患儿的年龄低于轻度患儿，延误诊断率、治疗不当率、入院时随机血糖、血肌酐和血尿素氮水平均明显高于轻度组，Na+、pH及HCO3-水平均明显低于轻度组患儿(P<0.05)。Logistic回归分析结果显示，延误诊断和治疗不当，年龄≤7岁、血尿素氮≥8.50 mmol/L及Na+≤135 mmol/L均为影响儿童DKA严重程度的独立危险因素(P<0.05)。结论 延误诊断、治疗不当、年龄偏小、血血尿素氮过高和Na+水平太低的患儿更容易发生中重度DKA,临床工作中要重点关注这些危险因素，加强对高危患儿的管控，做好早期预防，早期诊断以及积极治疗。 

关键词:

糖尿病酮症酸中毒, 严重程度, 危险因素, 防治对策

Abstract:

ObjectiveTo explore the risk factors of disease severity in children with diabetic ketoacidosis(DKA).MethodsTotally 60 children with DKA were collected from Oct.2017 to Oct.2020.The children were then divided into the mild group and moderate/severe group according to the severity of DKA,with 30 cases in each group.χ2 test and t test were used to analyze the children′s general data,clinical data,living habits,treatment methods,laboratory test results on admission,etc.Logistic regression analysis was applied to determine the relevant risk factors that affect the severity of DKA in order to explore the scientific and effective strategies for prevention and treatment.ResultsUnivariate analysis showed that the age of children in the moderate/severe group was lower than that of the children in the mild group,and the rate of delayed diagnosis,rate of improper treatment,random blood glucose,Scr and BUN levels on admission were significantly higher than those in the mild group.The Na+,pH and HCO3- levels were significantly lower than those in the mild group(P<0.05).Logistic regression analysis showed that delayed diagnosis and improper treatment,age≤7 years,blood urea nitrogen(BUN)≥8.50 mmol/L,and Na+≤135 mmol/L were independent risk factors that affected the severity of children′s DKA(P<0.05).ConclusionChildren with delayed diagnosis,improper treatment,younger age,high blood BUN and low Na+ level are more likely to develop moderate/severe DKA.Clinical work should focus on these risk factors and strengthen the management and control should be strengthened in high-risk children.Early prevention,early diagnosis and active treatment should be performed.

Key words:

Diabetic ketoacidosis, Severity, Risk factors, Prevention and treatment strategies