BMJ:成人糖尿病酮症酸中毒须知

2015-11-03 zhaoshuang 译 MedSci原创

 

糖尿病酮症酸中毒须知:

1.糖尿病酮症酸中毒(DKA)是一种常见的、严重的、可预防的1型糖尿病并发症,死亡率为3 - 5%。其他类型的糖尿病患者也可能出现糖尿病酮症酸中毒。

2.大约有6%的糖尿病病人的首发症状就是DKA。

3.DKA诊断不是很明显,当糖尿病患者出现任何不适时,都有可能是DKA。

4.DKA的诊断基于生化检测指标,但DKA患者血糖水平并不一定高,同时血酮水平低(<3 mmol/L)也不能排除DKA可能性。

5.DKA紧急治疗包括静脉注射胰岛素和钾,仔细监测血糖和钾水平,避免低血糖和低钾血症。

6.不管是几型糖尿病,出现DKA都应坚持胰岛素治疗。

7.后续处理应注重对病人的健康宣教,避免再次出现DKA。

8.在与DKA发作后患者应该由专业的多学科团队进行随访观察。

什么是糖尿病酮症酸中毒?


糖尿病酮症酸中毒(DKA)是由绝对胰岛素缺乏或相对胰岛素缺乏而导致的极端代谢状态。相对胰岛素缺乏可能使反调节激素水平上升如胰高血糖素、皮质醇和儿茶酚胺。胰岛素缺乏导致脂类分解产生酮体,酮体属于酸性物质,如果酮水平超过机体对酸性物质的缓冲能力时,则会出现酮症酸中毒。

糖尿病酮症酸中毒的出现几率

英国国家糖尿病审计数据显示,每年都会有大概3.6%的人患上1型糖尿病。在英国大约有4%的1型糖尿病患者出现过酮症酸中毒。


原始出处:

N S Oliver.Diabetic ketoacidosis in adults.BMJ.Clinical Review.28 October 2015


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    2016-08-25 gaoxiaoe
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    2016-01-05 xyfg98

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    2015-11-05 mashirong
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    2015-11-04 wwwwwwww

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