摘要
Abstract
Objective:To analyze the predictive efficacy of C reactive protein/lactic acid(CRP/LAC)and amylase(AMS)levels on the disease and secondary infection of patients with diabetic ketoacidosis(DKA).Method:A total of 82 patients with DKA admitted to Jiangxi Integrated Traditional Chinese and Western Medicine Hospital from January 2021 to July 2023 were included in the observation group.Taking the results of arterial blood gas analysis as the"gold standard",patients with mild and moderate DKA were included in the mild group(n=67),and patients with severe DKA were included in the severe group(n=15).Taking the results of blood culture and other etiological tests as the"gold standard",the patients with secondary infected were included in the infected group(n=35),and those without secondary infected were included in the uninfected group(n=47).In addition,40 diabetic patients without DKA were selected as control group in author's hospital during the same period.The differences of CRP/LAC and AMS levels between observation group and control group,mild group and severe group,infected group and uninfected group were retrospectively analyzed.The receiver operating characteristic(ROC)curve is used to describe the prediction of patients with DKA disease severity and secondary infection by using the above indexes alone or in combination.Result:The CRP/LAC and AMS levels in observation group were higher than those in control group,the CRP/LAC and AMS levels in severe group were higher than those in mild group,and the CRP/LAC and AMS levels in infected group were higher than those in uninfected group(P<0.05).The cut-off value of CRP/LAC alone for predicting severe DKA was 20.25,and that for predicting secondary infection alone was 18.38.The cut-off value of AMS levels alone for predicting severe DKA was 138.65 U/L,and that for predicting secondary infection alone was 120.55 U/L.The area under the curve(AUC)of the combined prediction of severe DKA was 0.782[95%CI(0.677,0.866)],the sensitivity was 89.55%,the specificity was 60.00%,and the AUC of the combined prediction of secondary infection was 0.925[95%CI(0.845,0.972)],the sensitivity was 85.11%and the specificity was 65.71%.Conclusion:The CRP/LAC and AMS levels in DKA patients with different severity and infection are obviously different.It is reliable to detect the above indexes in the early stage of admission to predict the disease and secondary infection.关键词
C反应蛋白/乳酸/糖尿病酮症酸中毒/继发感染/病情严重程度Key words
C reactive protein/Lactic acid/Diabetic ketoacidosis/Secondary infection/Disease severity
