• 四川巴中市人民醫(yī)院內分泌科，四川巴中 636000;

目的:提高臨床醫(yī)師對以腹痛為首發(fā)癥狀的肥胖型2型糖尿病酮癥酸中毒（DKA）并高脂血癥（HL）性急性胰腺炎（AP）的認識。方法:回顧性分析我院2005年1月至2008年3月收治的9例肥胖型2型糖尿病酮癥酸中毒并高脂血癥性急性胰腺炎患者的臨床資料。結果:（1）9例均為青年男性，年齡30.78±5.56歲；（2）病前均無糖尿病史及相關癥狀，均無高脂血癥史；（3）病前均無暴飲、暴食和膽石癥史；（4）均以腹痛為首發(fā)癥狀，均有腹壓痛；（5）均為肥胖體型，體質指數(shù)28.33±1.54 kg/m2；（6）均達到DKA診斷標準；（7）入院時有7例血淀粉酶升高，其中6例超過正常值3倍以上，2例正常（其中1例入院后升高達正常值3倍以上）；（8）入院時均有高脂血癥，其中3例脂血，6例TG均 gt;113 mmol/L，DKA糾正后（入院后第3天）TG降至1.1～1.8 mmol/L，TC降至3.6～4.6 mmol/L；（9）B超或CT均有胰腺炎改變；（10）治愈后癥狀解除，血TG、TC均正?；蛏愿?，血尿淀粉酶均正常。結論:（1）以腹痛就診的DKA患者，應常規(guī)查TG、TC、血尿淀粉酶、胰腺B超或CT，以排除高脂血癥性胰腺炎；（2）青年肥胖型2型糖尿病可能以糖尿病酮癥酸中毒并高脂血癥性急性胰腺炎為首發(fā)表現(xiàn)入院。

引用本文： 羅光濤. 9例肥胖型2型糖尿病酮癥酸中毒并急性胰腺炎臨床分析. 華西醫(yī)學, 2009, 24(1): 112-114. doi: 復制

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  3. 3. Nair S，Yadav D，Pitchumoni CS，et al.Association of diabetic ketoacidosis and acute pancreatitis:observations in 100 consecutive episodes of DKA[J].Am J Castroenterol，2000，95:2795-2800..
  4. 4. Haddad NG，Croffie JM，Eugster EA.Pancreatic enzyme elevations in children with diabetic ketoacidosis[J].J Pediatr，2004，145:122-124..
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  6. 6. Nair S，Pitchumoni CS.Diabetic ketoacidosis，hyperlipidemia，and acute pancreatitis:the enigmatic triangle[J].Am J Gastroenterol，1997，92:1560-1561..
  7. 7. Kimura N，F(xiàn)ujiya H，Yamaguchi K，et al.Vanished islets with pancreatitis in acuteonset insulindependent diabetes mellitus in an adult[J].Arch Pathol Lab Med，1994，118:8488.