一个嵌套的病例对照研究,研究了糖尿病酸性糖尿病儿童的不良结果
Maha F Yousif1, Katie D Dolak1, Soumya Adhikari1
1Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas TX.
The Journal of clinical endocrinology and metabolism
|December 10, 2024
概括
患有糖尿病酸性酸症 (DKA) 或高血糖-高分泌综合征 (HHS) 的儿童经历不良后果,经常出现高血症. 这种在入院时存在并且在治疗期间持续存在的情况与较差的结果有关,而不是管理差异.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 关键护理医学 关键护理医学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 儿科糖尿病酸症 (DKA) 和高血糖-超综合征 (HHS) 的不良结果可以通过综合风险评分来预测.
- 大多数高风险患者没有出现不良结果,因此需要确定其他影响因素.
研究的目的:
- 确定与儿科DKA-HHS的不良结果相关的临床特征和管理差异.
- 调查超出综合风险评分的因素,影响患者的治疗结果.
主要方法:
- 对4565名DKA-HHS (2010-2023) 的入院者进行了一项嵌套病例控制研究.
- 84个具有不良结果的病例与84个基于综合风险评分的对照进行了匹配.
- 分析的重点是初始临床数据和治疗过程的差异.
主要成果:
- 有不良结局的病例显示初始血清和BUN较高,以及更多的新发糖尿病.
- 高血糖症,酸症和高血症在病例组中缓慢地解决.
- 在液体给药或初始胰岛素剂量方面没有发现显著差异,但某些病例需要更长时间的静脉注射胰岛素.
结论:
- 住院时和在治疗的前24小时内持续的高血是儿科DKA-HHS中不良结果的关键指标.
- 这些不良结果并不能通过临床管理策略的差异来解释.
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