摘要
目的探究糖尿病酮症酸中毒感染患者血清降钙素原(PCT)、乳酸(LAC)、血小板/淋巴细胞比值(PLR)水平变化及其临床意义。方法将2017年7月-2018年7月于湖北文理学院附属医院急诊科收治的120例糖尿病酮症酸中毒感染患者作为感染组,将120例同期糖尿病酮症酸中毒但未合并感染的患者作为对照组。检测两组患者血清中PCT、LAC、PLR的表达水平。结果感染组患者血清中PCT、LAC、PLR表达水平均明显高于对照组(P<0.05)。血清PCT、LAC、PLR水平升高可以作为糖尿病酮症酸中毒合并感染的危险相关因素,OR值分别为3.147、2.857、3.012,且三者在总体分布方面有统计学意义(P<0.05)。血清中PCT、LAC、PLR三者联合进行诊断时曲线下面积为0.893,明显高于单一指标的结果,联合诊断的敏感性和特异性分别为86.2%、87.4%,明显高于单一指标。120例患者中存活75例,死亡15例,病死率为12.5%,其中病死患者的血清PCT、LAC水平均显著高于存活患者,差异有统计学意义(P<0.05)。结论对糖尿病酮症酸中毒感染患者进行血清PCT、LAC、PLR表达水平检测能够起到较好的预测作用,而且三项指标联合诊断价值高于三者单独的诊断效能。
Objective To explore the changes of procalcitonin(PCT),lactic acid(LAC)and platelet to lymphocyte ratio(PLR)levels in patients with diabetic ketoacidosis and their clinical significance,and provide a reference for early diagnosis.Methods 120 cases patients with diabetic ketoacidosis infection admitted to the emergency department of Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Sciences from July 2017 to July 2018 were selected as the infection group,and 120 cases patients with concurrent diabetic ketoacidosis but no complicated infection were selected as the non-infectious control group.The expression levels of PCT,LAC and PLR in serum of all patients were detected.Results The expression levels of PCT,LAC and PLR in serum of the infected group were significantly higher than those of the control group(P<0.05).Elevated serum PCT,LAC and PLR expression levels were the strongest risk predictors of diabetic ketoacidosis complicated with infection,with OR values of 3.147,2.857,and 3.012,respectively,and they have statistical significance in the overall distribution(P<0.05).When PCT,LAC and PLR were combined in serum for diagnosis,AUC(0.893)was significantly higher than that of the single factor,and its sensitivity(86.2%)and specificity(87.4%)were also higher than those of the single factor,and the difference was statistically significant(P<0.05).Conclusion In clinical practice,the detection of serum PCT,LAC and PLR expression levels in patients with diabetic ketoacidosis infection could play a better predictive role,and the combined diagnostic value of the three indicators was higher than the independent diagnostic efficiency of the three indicators.
作者
骆黎
何海玲
毛光宇
LUO Li;HE Hai-ling;MAO Guang-yu(Department of Emergency,Xiangynng CUy Center Hospital,Affiliated Hospital of Hubei University of Arts and Science,Xiangyang,Hubei 441021,China)
出处
《热带医学杂志》
CAS
2021年第2期234-237,共4页
Journal of Tropical Medicine
基金
湖北省卫生和计划生育委员会科研项目(WJ2015MB013)。
