一例突发型1型糖尿病和蛋白C缺乏症,并因深静脉血栓形成并发症
Masato Kohata1, Shinjiro Kodama1, Nobuhiro Yaoita2
1Department of Diabetes and Metabolism, Tohoku University Hospital, Sendai, Japan.
Journal of diabetes investigation
|June 16, 2023
概括
糖尿病酸性 (DKA) 可以导致严重的血栓形成,特别是在潜在的蛋白C (PC) 缺乏症的患者中. 早期抗凝治疗与DKA治疗相结合对于这些患者来说至关重要,以预防深静脉血栓塞 (DVT) 和肺栓塞 (PE).
科学领域:
- 内分泌学 在内分泌学.
- 血液学 血液学 血液学
- 血管医学 血管医学
背景情况:
- 爆发性1型糖尿病可能伴有糖尿病酸性酸症 (DKA).
- 深静脉血栓 (DVT) 和肺栓塞 (PE) 是DKA的潜在并发症,特别是在使用中央静脉导管时.
- 蛋白C (PC) 缺乏是发生血栓事件的已知危险因素.
研究的目的:
- 报告一个患有新诊断的DKA和I型部分PC缺乏症的患者的大型DVT和PE病例.
- 突出高血糖,PC缺乏和DKA治疗对血栓形成风险的潜在协同效应.
- 强调在DKA患有PC缺乏症的患者中考虑抗凝药的重要性.
主要方法:
- 一个25岁的男性在1型糖尿病发病时被诊断患有DKA的病例报告.
- 通过成像研究监测DVT和PE.
- 在DKA治疗期间和之后评估C蛋白活性和抗原水平.
主要成果:
- 在DKA治疗开始15天后,检测到大量的DVT和PE.
- 该患者表现出I型部分PC缺陷,PC活性较低,DKA治疗后抗原水平持续.
- 高血糖引起的PC抑制,部分PC缺乏,脱水和导管使用可能导致了血栓事件.
结论:
- 患有PC缺乏症的患者,即使是无症状的部分缺乏症,在DKA期间也面临高风险的DVT和PE.
- 对于患有PC缺乏症的患者,建议结合抗凝疗与急性阶段DKA管理.
- 静脉血栓栓塞应被认为是DKA的潜在严重并发症,特别是在高危人群中.
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