摘要
本文报告1例暴发性1型糖尿病合并败血症的诊断和治疗情况,并对其发病机理进行讨论。暴发性1型糖尿病起病急骤,病情严重,在较短的高血糖时间内发展成糖尿病酮症酸中毒,起病时胰岛β细胞的功能近乎完全损害,但糖尿病自身抗体多数呈阴性。而糖尿病患者因长期处于高血糖、机体代谢紊乱和免疫功能低下状态,易患多种感染性疾病,糖尿病病理状态时,机体内致病菌生长繁殖较快,病原菌难以完全去除,且感染易反复发作;同时感染可使高血糖及代谢紊乱加剧,二者相互影响,给患者健康状况及预后情况带来很大威胁。本病例起病前曾有上呼吸道感染病史,推测暴发性1型糖尿病的发生可能与病毒感染对胰岛β细胞的损伤有关,这为临床上探讨1型糖尿病的发病机理提供了线索。临床医生应对暴发性1型糖尿病提高认识、及早鉴别、积极救治。
This paper reports the diagnosis and treatment of a case of fulminant type 1 diabetes mellitus complicated with septicemia,and discusses its pathogenesis.The onset of fulminant type 1 diabetes is sudden and severe,and it develops into diabetic ketoacidosis within a short period of hyperglycemia.The function of pancreaticβcells is almost completely impaired at the onset of the disease,but most diabetic autoantibodies are negative.However,patients with diabetes are prone to a variety of infectious diseases due to long-term high blood glucose,metabolic disorders and immune dysfunction.In the pathological state of diabetes,pathogenic bacteria in the body grow and reproduce quickly,pathogenic bacteria are difficult to be completely removed,and infection is prone to recurrent attacks.Concurrent infection can aggravate hyperglycemia and metabolic disorders,which affect each other and pose a great threat to the health status and prognosis of patients.This case had a history of upper respiratory tract infection before the onset of the disease.It is speculated that the occurrence of fulmonant type 1 diabetes may be related to the damage of pancreaticβcells caused by viral infection,which provides clues for the clinical study of the pathogenesis of type 1 diabetes.Clinicians shall increase awareness,early identification and active treatment of fulminant type 1 diabetes.
作者
吴起润
钟君文
李兰芳
曾姣娥
WU Qirun;ZHONG Junwen;LI Lanfang;ZENG Jiao'e(Department of Endocrinology,Jingzhou Hospital Affiliated to Yangtze University,Jingzhou,Hubei Province,434020 China)
出处
《糖尿病新世界》
2023年第1期34-37,共4页
Diabetes New World Magazine
关键词
暴发性1型糖尿病
败血症
病例报告
Fulminant type 1 diabetes mellitus
Sepsis
Case report
