| 摘要: |
| ［摘要］目的 探讨血β-羟丁酸和尿酮在糖尿病酮症诊断中的临床价值．方法 选取2012年5月至2014年5月澄迈县人民医院收治的115例糖尿病非酮症患者（NDK组），85例糖尿病酮症患者（DK组）以及105例健康对照者（对照组）为研究对象．检测各组受试人员血β-羟丁酸、尿酮以及血糖水平；对NDK组和DK组患者血β-羟丁酸、尿酮以及血糖水平进行相关性分析；运用ROC曲线预测血β-羟丁酸对糖尿病酮症的最佳阈值．结果 DK组患者血β-羟丁酸水平、β-羟丁酸阳性率、尿酮体阳性率以及血糖水平均显著高于NDK组和NC组，差异具有统计学意义（P＜0.01）．相关性分析显示，血β-羟丁酸水平与尿酮及血糖均呈正相关（r＝0.552， P＜0.000；r＝0.405，P＝0.010）．以尿酮阳性为糖尿病酮症诊断的金标准，通过ROC分析得出血β-羟丁酸诊断的曲线下面积为0.839，最佳阈值为0.64 mmol/L，敏感性为81.6%，特异性为89.2%．结论 血β-羟丁酸及尿酮检测对糖尿病酮症的早期诊断均具有重要意义，血β-羟丁酸联合尿酮检测可减少糖尿病酮症的漏诊和误诊，血β-羟丁酸诊断糖尿病酮症的最佳阈值为≥0.64 mmol/L． |
| 关键词: ［关键词］血β-羟丁酸 尿酮 糖尿病酮症 |
| DOI： |
| 分类号: |
| 基金项目:［基金项目］海南省卫生厅医学科研课题基金资助项目（琼卫2013-资助-012） |
|
| The Clinical Value of Blood β-hydroxybutyric Acid and Urine Ketone in the Diagnosis of Diabetic Ketosis |
|
QIU Huang-xun1,2
|
|
1.（1）Dept. of Internal Medicine，Chengmai People’s Hospital，Chengmai Hainan 571900;2）Dept. of Internal Medicine，People’s Hospital of Haikou City，Haikou Hainan 570208，China）
|
| Abstract: |
| ［Abstract］Objective To investigate the clinical value of blood β-hydroxybutyric acid and urine ketone in the diagnosis of diabetic ketosis. Methods One hundred and fifteen patients with non-ketosis diabetics （NDK group）， 85 patients with diabetic ketosis（DK group）and 105 healthy people（control group）were enrolled in Chengmai People's Hospital from May 2012 to May 2014. Blood β-hydroxybutyric acid，urine ketone and blood glucose were detected; the correlation index of blood β-hydroxybutyric acid，urine ketone and blood glucose in NDK group and DK group were analyzed. The receiver operating characteristic curve（ROC）was performed in determining the diagnostic value of blood β-hydroxybutyric acid for diabetic ketosis. Results The level of blood β-hydroxybutyric acid， positive rate of blood β-hydroxybutyric acid， urine ketone and level of blood glucose in DK group were higher than those in NDK group and NC group （P＜0.01）. Blood β-hydroxybutyric acid was positively correlated with urine ketone and blood glucose （r＝0.552，P＝0.000；r＝0.405，P＝0.010）. When urine ketone was used as diagnostic standard， the area under curve of blood β-hydroxybutyric acid was 0.839， the best cutoff value of β-hydroxybutyric acid was 0.64 mmol/L with the sensitivity was 81.6% and specificity was 89.2%. Conclusions Examinations of blood β-hydroxybutyric acid and urine ketone have great significance for the diagnosis of diabetic ketosis. The co-monitoring of blood β-hydroxybutyric acid and urine ketone can reduce the rates of missed diagnosis and misdiagnosis. The best cutoff value of β-hydroxybutyric acid to diagnose diabetic ketosis was 0.64 mmol/L. |
| Key words: ［Key words］Blood β-hydroxybutyric acid Urine ketone Diabetic ketosis |