评估儿童糖尿病酸症诱导脑病变中的瞳孔光反射变化:使用定量瞳孔计量的回顾性分析
Elber Y Aydin1, Matthew Garber2, Jose Irazuzta3
1Pediatrics, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.
Cureus
|June 17, 2025
概括
定量瞳孔测量显示,糖尿病酸性脑病变 (DKAE) 的儿科患者的瞳孔反应较慢. 这些变化随着脑病变的缓解而暂时改善,这表明学生计量术.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 神经学 神经学
- 内分泌学 在内分泌学.
背景情况:
- 糖尿病酸性脑病变 (DKAE) 是糖尿病酸性脑病 (DKA) 的严重并发症.
- 儿科DKA患者的神经状态变化需要客观监测.
- 定量瞳孔测量为评估神经功能提供了一种潜在的非侵入性方法.
研究的目的:
- 研究患有DKA的儿科患者的瞳孔反应变化与神经状态之间的关联.
- 评估定量学生计在识别和监测DKAE中的实用性.
主要方法:
- 对21名患有DKA的儿科患者 (6-17岁) 进行了回顾性审查,这些患者被录入PICU.
- 瞳孔测量 (收缩速度[CV]和最大收缩速度[MCV]) 在入院时 (T0) 和在DKA/DKAE分辨率 (T1) 后测量.
- 使用ROC曲线分析,对患有脑病和没有脑病的患者之间的瞳孔参数进行比较.
主要成果:
- 在T0时,与没有脑病变的患者相比,在脑病变患者中观察到显著较低的CV和MCV.
- 在脑病组中,随着时间的推移,瞳孔速度显著改善,在T1.1时正常化.
- ROC分析表明,CV (3.26 mm/s) 和MCV (4.545 mm/s) 的最佳切割值用于检测脑病变,具有高灵敏度和特异性.
结论:
- DKAE与暂时减少的瞳孔收缩速度有关,表明自主功能障碍.
- 定量瞳孔测量是一种有前途的非侵入性工具,用于监测儿科DKA患者的神经状态.
- 需要进一步的研究来探索自主神经系统功能障碍在DKAE病理生理学中的作用.
相关概念视频
01:25Diabetic Ketoacidosis l: Introduction
DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
01:22Diabetic Ketoacidosis ll: Pathophysiology
Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
01:27Diabetic Retinopathy
DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...