Clinical Analysis of 9 Cases of Obese Type Ⅱ Diabetes and Ketoacidosis Combined with Acute Pancreatitis_West China Medical Journal

Authors：

LUO Guangtao

Department of Endocrinology，BaZhong People’s Hospital，Bazhong Sichuan 636000，China;

Corresponding author：

Keywords：

肥胖; 2型糖尿病酮症酸中毒; 高甘油三脂血症; 急性胰腺炎

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目的:提高临床医师对以腹痛为首发症状的肥胖型2型糖尿病酮症酸中毒（DKA）并高脂血症（HL）性急性胰腺炎（AP）的认识。方法:回顾性分析我院2005年1月至2008年3月收治的9例肥胖型2型糖尿病酮症酸中毒并高脂血症性急性胰腺炎患者的临床资料。结果:（1）9例均为青年男性，年龄30.78±5.56岁；（2）病前均无糖尿病史及相关症状，均无高脂血症史；（3）病前均无暴饮、暴食和胆石症史；（4）均以腹痛为首发症状，均有腹压痛；（5）均为肥胖体型，体质指数28.33±1.54 kg/m2；（6）均达到DKA诊断标准；（7）入院时有7例血淀粉酶升高，其中6例超过正常值3倍以上，2例正常（其中1例入院后升高达正常值3倍以上）；（8）入院时均有高脂血症，其中3例脂血，6例TG均 gt;113 mmol/L，DKA纠正后（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均有胰腺炎改变；（10）治愈后症状解除，血TG、TC均正常或稍高，血尿淀粉酶均正常。结论:（1）以腹痛就诊的DKA患者，应常规查TG、TC、血尿淀粉酶、胰腺B超或CT，以排除高脂血症性胰腺炎；（2）青年肥胖型2型糖尿病可能以糖尿病酮症酸中毒并高脂血症性急性胰腺炎为首发表现入院。

Citation： LUO Guangtao. Clinical Analysis of 9 Cases of Obese Type Ⅱ Diabetes and Ketoacidosis Combined with Acute Pancreatitis. West China Medical Journal, 2009, 24(1): 112-114. doi: Copy

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1. Vague J.The degree of masculine differentiation of obesities:a factor determining predisposition to diabetes，atherosclerosis，gout and uric calculous dicease[J].Am J Clin Nutr，1956，4:20-34..
2. Vanitallie TB.Body weight，morbidity，and longevity.In:Bjorntorp P，Brodoff BN，eds.Obesity.Philadelphia:JB Lippincott Co，1992..
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. Haddad NG，Croffie JM，Eugster EA.Pancreatic enzyme elevations in children with diabetic ketoacidosis[J].J Pediatr，2004，145:122-124..
5. Yadav D，Pitchumoni CS.Issues in hyperlipidemic pancreatitis[J].J Clin Gastroenterol，2003，36:54-62..
6. Nair S，Pitchumoni CS.Diabetic ketoacidosis，hyperlipidemia，and acute pancreatitis:the enigmatic triangle[J].Am J Gastroenterol，1997，92:1560-1561..
7. Kimura N，Fujiya 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.

West China Medical Journal

Clinical Analysis of 9 Cases of Obese Type Ⅱ Diabetes and Ketoacidosis Combined with Acute Pancreatitis

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