摘要
目的了解四川大学华西医院1997～2005年住院糖尿病酮症（DK）患者的临床特征以及变化趋势，为本地区DK的临床流行病学研究提供初步资料。方法回顾性收集四JII大学华西医院1997～2005年所有出院诊断中包含“糖尿病酮症（含酸中毒）”的各科患者的病历资料，分析全部DK患者的临床资料及实验室检查数据。结果1997～2005年间住院DK患者在糖尿病患者中的构成比以平均每年0．12％的速度增长。其中应激性酮症患者在DK患者中的构成比无明显变化，自发性酮症中1型糖尿病酮症（T1D-DK）患者在DK患者中的构成比以平均每年2．00％的速度下降，而肥胖伴自发性酮症（OB-DK）患者在DK患者中的构成比以平均每年2．27％的速度增加。OB-DK患者以男性居多，平均起病年龄大于T1D-DK患者，有糖尿病家族史者及合并高血压、高尿酸血症／痛风、血脂紊乱及脂肪肝者较多，而胰岛0细胞功能较TID-DK患者好。结论近年来OB-DK患者在DK患者中的构成比明显上升，其临床特征与T1D-DK患者迥异，OB—DK可能是2型糖尿病的一种亚型。
Objective To evaluate the clinical features and epidemiological trend of diabetes ketosis （DK） in patients admitted to West China Hospital. Methods We reviewed medical records of diabetic patients with DK who were admitted to West China Hospital from 1997 to 2005. Their clinical and laboratory data were analysed with SAS 9.0. Results From 1997 to 2005, the proportion of diabetic patients with DK increased by 0.12% annually. The proportion of provoked DK patients （who bad a clinically evident precipitating factor） in those with DK remained stable; whereas the proportion of T1D patients in those with DK declined by 2.00% annually and the proportion of ketosis prone obesity diabetes （KPD） in those with DK increased by 2.27~ annually. The KPD patients displayed a striking male predominance （2.31 ： 1, male ; female） and were diagnosed at an older age compared with those with T1D [（46.3±12.9） yr. vs. （28.9±14.7） yr. ]. The KPD patients were more likely to have a strong family history of diabetes and a better 13-cell function reserve, and be accompanied with dyslipidemia （52. 7%）, hypertension （23.3%）, fatty liver （10. 1%） and hyperuricemia/gout （8.5%） compared with those with TID. Conclusion In recent years the proportion of KPD patients in the hospitalized DK patients is increasing. With different characteristics compared with typical T1D, KPD might belong to a subgroup of T2D.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2013年第6期950-953,共4页
Journal of Sichuan University(Medical Sciences)
