| 荀泽丽,王旭艳,李 佳,胡姝雯,刘 超,高飞飞.胰岛素联合补钾对小儿糖尿病酮症酸中毒疗效及对1,5-AG、β-HB影响[J].,2020,(22):4262-4265 |
| 胰岛素联合补钾对小儿糖尿病酮症酸中毒疗效及对1,5-AG、β-HB影响 |
| Effect of Insulin Combined with Potassium Supplementation on Pediatric Diabetic Ketoacidosis and Effects on 1,5-AG and β-HB |
| 投稿时间：2020-02-28 修订日期：2020-03-23 |
| DOI：10.13241/j.cnki.pmb.2020.22.013 |
| 中文关键词: 胰岛素 补钾 小儿糖尿病酮症酸中毒 1,5-AG β-HB |
| 英文关键词: Insulin Potassium supplementation Pediatric diabetic ketoacidosis 1,5-AG β-HB |
| 基金项目:陕西省社会发展科技攻关项目（2015SF215） |
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| 中文摘要: |
| 摘要 目的：探讨胰岛素联合补钾对小儿糖尿病酮症酸中毒疗效及对1,5-脱水葡糖苷(1,5-anhydroglucitol，1,5-AG)、β羟丁酸(β-hydroxybutyricacid，β-HB)影响。方法：选取我院2016-2019年所收治的120例小儿糖尿病酮症酸中毒患者，根据胰岛素不同剂量，将其分为研究组和对照组，每组患儿60例，两组患儿均予以补钾等常规治疗，在此基础上，研究组患儿联合小剂量胰岛素，对照组患儿联合大剂量胰岛素，对比不同治疗方案的疗效及对1,5-AG、β-HB影响。结果：两组患儿治疗前血糖、1,5-AG对比无统计学差异（P＞0.05），治疗后，研究组患儿血糖及1,5-AG明显优于对照组（P＜0.05）；两组患儿治疗前血清β-HB、白介素6(interleukin，IL-6)、IL-10对比无统计学差异（P＞0.05），治疗后，两组患儿相关指标均较治疗前明显降低（P＜0.05），其中研究组患儿治疗后β-HB明显低于对照组（P＜0.05），而两组患儿治疗后IL-6、IL-10对比无统计学差异（P＞0.05）；两组患儿治疗有效率对比无统计学差异（P＞0.05）；研究组患儿并发症发生率明显低于对照组（P＜0.05）。结论：小剂量胰岛素联合补钾对小儿糖尿病酮症酸中毒疗效良好，可改善患儿炎症反应，促使临床症状改善，升高1,5-AG，降低β-HB，因此，在临床治疗中，需全面评估患儿病情，结合患儿实际情况，合理选择胰岛素剂量，保证患儿最佳治疗效果。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of insulin combined with potassium supplementation on diabetic ketoacidosis and the effects on 1,5-AG and β-HB. Methods: 120 patients with pediatric diabetic ketoacidosis admitted to our hospital from 2016 to 2019 were divided into study group and control group according to different doses of insulin. 60 children in each group were given potassium supplementation. On the basis of routine treatment, the study group combined with low-dose insulin, the control group combined with high-dose insulin, compared the efficacy of different treatment options and the impact on 1,5-AG, β-HB. Results: There was no significant difference in pre-treatment blood glucose and 1,5-AG between the two groups (P>0.05). After treatment, the blood glucose and 1,5-AG of the study group were significantly better than the control group (P<0.05). There was no significant difference in serum β-HB, IL-6 and IL-10 between the two groups (P>0.05). After treatment, the related indexes of the two groups were significantly lower than those before treatment (P<0.05). The β-HB of the study group was significantly lower than that of the control group (P<0.05), but there was no significant difference in IL-6 and IL-10 between the two groups (P>0.05). There was no significant difference in the effective rate of treatment (P>0.05). The incidence of complications in the study group was significantly lower than that in the control group (P<0.05). Conclusion: Low-dose insulin combined with potassium supplementation is effective in children with diabetic ketoacidosis, which can improve the children's inflammatory response, promote clinical symptoms, increase 1,5-AG, and lower β-HB. Therefore, in clinical treatment, It is necessary to comprehensively evaluate the condition of the child, and combine the actual situation of the child to reasonably select the insulin dose to ensure the best therapeutic effect of the child. |
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