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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。
Objective: To analyze the clinical features and prognosis of patients with acute complications of diabetes complicated with rhabdomyolysis, and to provide basis for clinical diagnosis and treatment in time. Methods: From January 2003 to May 2009 in our hospital access to patient data, diabetic ketoacidosis and hyperglycemia in patients with elevated or not according to creatine kinase, divided into elevated serum creatine kinase group (Group A) and normal serum creatine kinase group (group B). The clinical characteristics and prognosis of the two groups were compared. Results: In group A and group B, serum urea nitrogen, creatinine and myoglobin in group A were significantly higher than those in group B. The hospitalization time was significantly longer in group A than in group B. The difference was statistically significant Significance (P <0.05). Three patients in group A had a serum creatine kinase of more than 1000 U / L, which was consistent with the diagnostic criteria of rhabdomyolysis syndrome. Conclusions: Patients with diabetic ketoacidosis and hyperglycemia should pay attention to muscle enzyme test, early diagnosis of rhabdomyolysis syndrome, protection of renal and pancreatic β-cell function, and shortening hospitalization time.