糖尿病急性并发症合并横纹肌溶解患者临床特征及预后

目的:分析糖尿病急性并发症患者合并横纹肌溶解的临床特征及预后,为临床及时诊断和治疗提供依据。方法:对我院2003年1月～2009年5月住院患者查阅病例资料,糖尿病酮症酸中毒及高血糖高渗状态患者根据肌酸激酶升高与否,分为血清肌酸激酶升高组(A组)和血清肌酸激酶正常组(B组),比较两组临床特征及预后。结果:A、B两组比较,A组较B组血清尿素氮、肌酐、肌红蛋白明显升高,住院时间明显延长,但出院时A组较B组每天每公斤胰岛素剂量减少,差异有统计学意义(P<0.05)。A组中3例患者血清肌酸激酶大于1000U/L,符合横纹肌溶解综合征诊断标准。结论:糖尿病酮酸中毒及高血糖高渗状态患者应重视肌酶检查,早期诊断横纹肌溶解综合征,保护肾脏和胰岛β细胞功能,缩短住院时间。

The Clinical Features and Prognosis of Patients with Acute Diabetic Complication and Rhabdomyolysis

Objective: To analyze the clinical features and prognosis of patients with acute diabetic complication and rhabdomyolysis,and to provide evidence for clinical diagnosis and treatment.Methods: Reviewed the data of patients with diabetic ketoacidosis and hyperosmolar hyperglycemic state in the people’s hospital of Hunan Province from January 2003 to May 2009.The patients were divided into two groups according to the levels of serum creatine kinase(Group A>175U/L,Group B≤175U/L),and compared the clinical features and prognosis of the patients in two groups.Results: Compared with Group B,the patients in Group A had higher levels of serum urea nitrogen,creatinine and myoglobin,and longer time of hospitalization.But the daily insulin dosage per kilo of patients in Group A was significantly lower than that of Group B.Three patients in group A were diagnosed rhabdomyolysis whose serum creatine kinase were higher than 1000U/L.Conclusio: Serum creatine kinase should be tested in patients with diabetic ketoacidosis and hyperosmolar hyperglycemic state,so patients with rhabdomyolysis can be early diagnosed and well treated.