摘要
目的分析单中心住院儿童1型糖尿病的临床表现特点及实验室检查。通过初发相关影响因素探讨儿童糖尿病发生糖尿病酮症酸中毒(DKA)的高危因素,以便早期预防和识别。方法回顾性分析新疆医科大学第一附属医院儿童内分泌病房2015年1月至2020年12月收治的316例新诊断的儿童1型糖尿病患儿的病历资料,按照有无DKA进行分组比较,观察2组在年龄、性别、BMI、临床症状、前驱感染史、糖尿病家族史、居住地、PH值、钠、钾、血浆渗透压、随机血糖、C肽、糖化血红蛋白、甲状腺功能、维生素D等方面的差异。结果316例T1DM患儿临床症状依次为:多饮86.3%、多尿85.9%、多食56.5%、体重下降54.5%、感染40%、深大呼吸36.5%、乏力23.9%、腹痛、呕吐等消化道症状27.5%、神经系统症状15.7%。T1DM患儿316例,男155例(48.3%),发病时有糖尿病症状患儿277例(86.3%),合并DKA 172例(54.4%),5岁以下DKA发生率为74.6%。≥1种糖尿病抗体阳性28例(8.7%),合并自身免疫性甲状腺疾病40例(12.65%),合并维生素D缺乏93例(29.4%)。DKA多因素Logistic回归分析显示居住地、随机血糖、糖化血红蛋白、C肽为DKA的独立影响因素。结论在初发1型糖尿病患儿中居住地在农村、随机血糖高、糖化血红蛋白高、C肽低的患儿更易发生DKA。对具有以上特点的糖尿病患儿应给予多加关注。
Objective To analyze the clinical characteristics and laboratory examination of type 1 diabetes mellitus in single center hospitalized children.To explore the risk factors of DKA in children with diabetes mellitus through early related factors,so as to prevent and identify them in early stage.Methods A retrospective analysis of 316 cases of newly diagnosed children with type 1 diabetes from January 2015 to December 2020 in the pediatric endocrinology ward of the First Affiliated Hospital of Xinjiang Medical University was carried out.According to whether there was a group of DKA.Differences in age,gender,BMI,clinical symptoms,history of previous infection,family history of diabetes,residence,p H,sodium,potassium,plasma osmotic pressure,blood glucose,C-peptide,glycosylated hemoglobin,thyroid function,vitamin D and other aspects were observed between the two groups.Results The clinical symptoms of 316 children with T1 DM were as follows:polydipsia 86.3%,polyuria 85.9%,polydipsia 56.5%,weight loss 54.5%,infection 40%,deep breathing 36.5%,fatigue 23.9%,gastrointestinal symptoms such as abdominal pain and vomiting 27.5%and neurological symptoms15.7%.There were 316 cases of T1 DM,155 males(48.3%),277 cases(86.3%)with diabetes symptoms,172 cases(54.4%)combined with DKA,and 74.6%cases of DKA under 5 years old.There were more than 1 diabetes antibodies positive in 28 cases(8.7%),autoimmune thyroid disease in 40 cases(12.65%),and vitamin D deficiency in 93 cases(29.4%).Multivariate logistic regression analysis of DKA showed that residence,random blood glucose,glycosylated hemoglobin and C-peptide were the independent influencing factors of DKA.Conclusion In children with newly diagnosed type 1 diabetes,children living in rural areas,children with high blood glucose,high glycated hemoglobin and low C peptide are more likely to develop DKA.More attention should be paid to diabetic children with these characteristics.
作者
罗燕飞
阿皮耶提·麦麦提图尔荪
玛依拉·阿不都热依木
米热古丽·买买提
LUO Yanfei;Apiyeti·Maimaitituersun;Mayila·Abudureyimu;Mireguli·Maimaiti(The First Affiliated Hospital of Xin jiang Medical University,Urumqi 830054,China;Moyu County people's Hospital,Hotan 848000,Xinjiang,China)
出处
《新疆医学》
2022年第1期18-21,17,共5页
Xinjiang Medical Journal
基金
新疆维吾尔自治区自然科学基金(项目编号:2019D01C301)
关键词
糖尿病
儿童
酮症酸中毒
临床特点
危险因素
Diabetes Mellitus
Children
Ketoacidosis
Clinical Characteristics
Risk Factors
作者简介
罗燕飞,女,硕士,主治医师,研究方向:内分泌遗传代谢性疾病;通信作者:米热古丽·买买提,女,博士,教授、主任医师,研究方向:内分泌遗传代谢性疾病,E-mail:milikita17@aliyun.com。
