新发儿童1型糖尿病酮症酸中毒与重症儿童应激性高血糖的鉴别诊断.docxVIP

山东大学硕士学位论文 FCP及IRJ均显著升高，H1)Alc(6．5％，GSP在DKA组较SHG组显著升高。且DKA 的治疗依赖胰岛素，而SHG组治疗不依赖胰岛素。 关键词： 1型糖尿病酮症酸中毒，应激性高血糖，鉴别诊断指标，儿童， 山东大学硕士学位论文 DIFFERENTIAL DIAGNoSIS oF NEWLY DIAGNOSED TYPE 1 DIABETIC KEToACIDoSIS WITH STRESS HYPERGLYCEMIA IN CRITICAL CHILDREN PATIENTS Postgraduate：Zhao Shu—yan Tutor： Pro￡LI Gui—mei Specialty： Pediatrics ABSTRACT objective： To inqu时into tlle di盱crential dia朗ostic indexes of newly diagnosed type 1 diabetic ketoacidosis(DKA)with stress hyperglycemia(SHG)in critical children patients． Methods： Thirty cases with DKA aged(6．5士3．6)years atld 20 critical cases with SHG patients电ged (j．8士3：1)’years w玳 prospectively s砌ied． Glycosylated hem0910bin(HbAl c)，glycosylated semm protein(GsP)，f如ting blood gIucose(FBG)， carbon dioxide combining po、ve“C02一CP)，anion gap(AG)，f如ting C—peptide(FCP)， fasting i11sulin(FINS)，insulin resistence index(IRI)，conisoI(COR)aIld if iIlsulin dependence were compared between DKA alld SHG group．Thiny healnly children agcd(6．1士3．4)years Served as no册al controls(C group)．There were no di丘毫fence among groups in age and gender，p0．05。 ResuJts： (1)1k concentrations ofFBG were si印诋cantly hi曲er in both DKA锄d SHG thaIl tIle group C(PO．001)，aIld It was hi曲er in group DKA t11an in group SHG(po．05)．But mere w够a oVerl印of FBG between DKA aIld SHG at 95％ confidence interval(CI)， (2)11le concentration of HbAlc in DKA was sigIlmcaIltly higllerthaIl both 4 坐查盔兰堡主堂垡垒塞 ．—— group SHG雒d C(p瑚．001)．111crc、懈∞significantly di髓rence be帆cn group SHG锄d C@，0．05)．And me伦啪s∞oved矩of HbAlc bctween DKA她d SHG at 95％CI．HbAlc7．3％in DKA，孙d HbAlc《．5％in SHG． (3)111e conc en_雠ation ofGsP in group DKA w笛si嘶ficamly hi曲cr tll孤botll group sHG趾d C．砧e concen仃ation of GsP was sigllific枷y hi曲er洫group SHG thaning刚pC，but恤rcw弱no overl印ofGsPb咖eeIlDKA aIld SHG at 95％CI· GSP550“mol几in DKA，aIld GSP(203岬ol／L in SHG (4)The concen仃ationsofC02．CPwere sigllificantlylowcrinbotllgrollpDKA aIld SHG thaIl in group C(pO．001)，aIld it、v嬲si鲥ficantly lower in gmup DKA m锄 in