Patients With Type2Diabetes Lactic Acid Level And Its Influencing Factors Of Inquiry

OBJECTICE: Through the detection of216cases of type2diabetic serumlactic acid level of patients and its influencing factors, Type2diabetic bloodlactic acid levelAnd to provide the basis for the occurrence and metformin drugtreatment of diabetic clinical prevention of lactic acidosis.Method:1.The object of study:2013September to2014February in thechoice of wide medicineDepartment of Endocrinology and metabolism, Department of the FirstAffiliated Hospital of university hospital were studied. Patients aged16~81years old, The median age:55years old. There were117males,89females.2.Check the project:○1Of all subjects to conduct a comprehensive physicalexamination, measurement of height, Calculation of BMI(BMI=kg/m2.○2Thefasting blood and retention samples: Blood lactic acid(Hitachi7600-20automatic biochemical analyzer and the British Landau Kit), serum creatinine,liver function(American BECKMAN LX20automatic biochemical analyzer), Using the Cockcroft-Gault formula: GFR=(140-age)×weight×88.4/(72×Cr)(female×0.79) calculated glomerular filtration rate.○3The statistical analysis:Count data using chi square test, The measurement data using mean+standarddeviation said, Test data normality distribution, The level of blood lactic acidbefore and after taking metformin compared using the paired t test; According toage, BMI, PaO2, PaCO2,GFR of subgroup analysis, Groups were comparedusing analysis of variance, And Pearson correlation analysis and multiplestepwise regression analysis of the influencing factors of type2diabetic patientswith elevated blood lactic acid level. All the statistics done by SPSS16.0software, P＜0.05, the difference was statistically significant.Result：1.206cases of patients with type2diabetes, Blood lactate wasnormal in46cases, Increased blood lactate levels in patients with160cases,accounting for78%,There were no acidosis.2.The use of metformin in the treatment of94cases of patients afteradmission, Before the treatment of lactic acid average(3.16±0.74) mmol/L,After the treatment of lactic acid average of (3.29±0.85) mmol/L,No significantdifference before and after1weeks treatment, the lactic acid level (P>0.05).3.Analysis of Effect of blood lactic acid level factors○1age and gender: Women: women were divided into4groups according toage: Age (years old)≤45,46~55,56~65,≥66comparison, Age group of bloodlactic acid level in56~65is greatly reduced, But the two two among each agegroup had no statistical significance (P>0.05). Men of blood lactic acid level in56-65group was higher than that of blood lactate levels in females in the sameage group, but no significant difference (P>0.05).○2Course of disease: According to the course of the disease patients weredivided into four groups, With the course of the increase, blood lactate levels are on the rise, But there was no significant difference between the two two groups(P>0.05)○3BMI: In BMI patients were divided into three groups (<24,24~28,>28)different BMI subgroups of blood lactate levels found, With the increase of BMI,Blood lactate levels also showed a rising trend, In BMI>28increasedsignificantly after, There was statistical significance compared with BMI <24group differences (P <0.05).○4PaCO2: In PaCO2patients were divided into three groups (PaCO2<35,35~40, mmHg>45), compared there was no significant difference (P>0.05,).○5PaO2:In PaO2patients were divided into three groups (PaO2<70,70~80,mmHg>80), Comparison of different lactic acid level in each PaO2levelshowed that with the increase of PaO2, The blood lactate level has decreased.PaO2>80mmHg minimum, Compared with PaO2<70mmHg group wasstatistically significant (P <0.05).○6GFR: In GFR patients were divided into3groups (GFR <60,60~90,and90ml/min) are compared, Blood lactate levels in male patients withdecreased with elevated levels of GFR, GFR>90blood lactate level minimum,GFR <60group blood lactate level was significantly higher than other groups,Compared with the other groups was statistically significant (P <0.05), Whilewomen are among the groups were compared, no significant difference (P>0.05).Correlation analysis of patients with type2diabetes lactic acid level show:Fasting blood La level was positively correlated with age, course ofdisease,BMI, and negative correlation with PaO2,GFR, there was statisticallysignificant (P <0.05), But with PaCO2had no obvious correlation. Furthermultiple regression analysis showed that only PaO2, BMI is independently associated with serum LA.Conclusion:1.In patients with type2diabetes, blood lactic acid level isgenerally higher,78%patients were higher than normal level.2.Age, body mass index, course of disease and lactic acid was positivelycorrelated, the partial pressure of oxygen, GFR and lactic acid was negativelyrelated to, The course of disease, blood lactic acid PaO2as independent factor.Overweight or disease for more than10years in patients with clinically shoulddetect the blood lactate concentration, May be complicated with lung and heartdysfunction in type2diabetes patients should choose metformin detection ofpartial pressure of oxygen after.