Changes of serum procalcitonin and lactate levels in patients with diabetic ketoacidosis complicated with infection and its clinical significance
10.3760/cma.j.issn.1008-6706.2019.14.020
- VernacularTitle: 糖尿病酮症酸中毒并发感染患者血清降钙素原、乳酸水平变化及临床意义
- Author:
Saisai KE
1
Author Information
1. Department of Internal Medicine Five, Wenling Hospital of Traditional Chinese Medicine, Wenling, Zhejiang 317500, China
- Publication Type:Journal Article
- Keywords:
Diabetic ketoacidosis;
Calcitonin;
Lactic acid;
Infection;
Diagnostic value
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(14):1741-1745
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changes and clinical significance of serum procalcitonin (PCT) and lactate levels in patients with diabetic ketoacidosis (DKA).
Methods:A total of 112 patients with DKA admitted to Wenling Hospital of Traditional Chinese Medicine from June 2016 to June 2018 were enrolled.Thirty-five healthy controls in our hospital were selected as the control group.White blood cell counts (WBC), ketone bodies, creatinine (Scr), urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), PCT and lactic acid were measured in each group.
Results:Compared with the control group, the WBC [(10.26±4.19)×109+/L vs.(14.81±3.79)×109/L], ketone bodies [(2.36±0.79) mmol/L vs.(6.25±1.02)mmol/L], Scr [(116.51±41.47)μmol/L vs.(113.15±37.68)μmol/L], BUN [(76.15±17.33)ng/L vs.(143.64±16.59)ng/L], ALT [(81.65±22.56)U/L vs.(79.36±25.34)U/L], AST [(61.38±12.52)U/L vs.(78.37±11.74)U/L], PCT [(1.53±0.59)ng/mL vs.(5.75±1.21)ng/mL] and lactic acid [(3.67±0.56)mmol/L vs.(10.31±2.51)mmol/L] levels in the uninfected group and the infected group were significantly increased, the differences were statistically significant (t=3.706, 10.841, 13.484, 32.826, 8.195, 8.465, 23.546, 48.493, 13.622, 11.715, 13.115, 21.148, 11.979, 26.426, 34.766, 23.538, all P<0.05). Compared with the uninfected group, the WBC [(14.81±3.79)×109+/L], ketone body [(6.25±1.02)mmol/L], BUN [(143.64±16.59)ng/L], AST [(8.37±11.74)U/L], PCT [(5.75±1.21)ng/mL] and lactic acid [(10.31±2.51)mmol/L] levels of the infected group were significantly increased (t=5.349, 19.230, 18.559, 6.547, 19.225, 15.383, all P<0.05). Multivariate logistic regression analysis showed that serum lactate and PCT levels were stronger factors in patients with DKA.The ROC analysis showed that the areas under the ACU of PCT, lactic acid and combined detection were 0.849, 0.805 and 0.930, respectively.The sensitivity (90.91%) and specificity (89.47%) of the combined detection were better than the separate tests (PCT: 78.33% and 82.69%, lactic acid: 70.18% and 70.91%) (sensitivity χ2=3.398, 7.092, specificity χ2=3.896, 0.048, all P<0.05).
Conclusion:The serum PCT and lactate levels of DKA patients are significantly higher than healthy people, and those in the infected patients are higher than the uninfected patients.The combined detection of these two indicators has higher value in the diagnosis of patients with DKA co-infection.
