儿科住院糖尿病儿童的临床流行病学特点

陆桃精 邱俊霖

【摘要】 目的：分析住院的儿童糖尿病患儿的临床流行病学特点。方法：收集本院儿科2012年1月-2019年12月糖尿病患儿的临床资料，对糖尿病患儿的分型、年龄、性别、发病月份及酮症酸中毒等情况进行回顾性分析。结果：自2012年1月-2019年12月，本院共收治糖尿病患儿60例，其中男23例，女37例。2例为2型糖尿病（T2DM），其他58例为1型糖尿病（T1DM）。发病年龄分布：1～4岁者11例，5～9岁者23例，10～13岁者26例。其中，糖尿病酮症酸中毒（DKA）38例（63.3%），39例合并感染（65.0%）。感染患儿中，呼吸道感染37例（94.9%），消化道感染2例（5.1%）。其中新诊断的糖尿病患儿30例，其中28例为T1DM，2例为T2DM。8年间，住院的糖尿病儿童及新发的糖尿病儿童呈现逐年增加的趋势。结论：住院糖尿病患儿仍以T1DM为主，合并DKA及合并感染的比例较高，女性病例多于男性。住院的糖尿病儿童及新发的糖尿病儿童呈现逐年增加的趋势，需引起重视。

【关键词】 糖尿病 儿童 流行特征

[Abstract] Objective： To analyze the clinical epidemiological characteristics of hospitalized children with diabetes mellitus. Method： The clinical data of children with diabetes mellitus in our hospital from January 2012 to December 2019 were collected， and the classification， age， gender， onset month and ketoacidosis of children with diabetes mellitus were retrospectively analyzed. Result： From January 2012 to December 2019， 60 children with diabetes mellitus were treated in our hospital， including 23 males and 37 females. 2 cases were type 2 diabetes mellitus （T2DM）， and the other 58 cases were type 1 diabetes mellitus （T1DM）. Age distribution： 11 cases were 1 to 4 years old， 23 cases were 5 to 9 years old， 26 cases were 10 to 13 years old. Among them， 38 cases （63.3%） were diabetic ketoacidosis （DKA） and 39 cases （65.0%） were complicated with infection. Among the infected children， 37 cases （94.9%） had respiratory tract infection and 2 cases （5.1%） had digestive tract infection. Among 30 newly diagnosed children with diabetes mellitus， 28 cases were T1DM and 2 cases were T2DM. In the past 8 years， the number of hospitalized and newly diagnosed diabetic children has increased year by year. Conclusion： T1DM is still the main type of diabetes mellitus in hospitalized children， and the proportion of DKA and infection are higher， female cases are more than male cases. The number of hospitalized and newly diagnosed diabetic children is increasing year by year， which needs attention.

[Key words] Diabetes mellitus Children Epidemic characteristics

First-authors address： The Ninth Affiliated Hospital of Guangxi Medical University， Beihai 536000， China

doi：10.3969/j.issn.1674-4985.2021.09.013

兒童出现糖尿病，对于家庭是一个沉重的负担，而儿科医生及内分泌医生对此认识不足，造成了部分糖尿病儿童的诊治不够完善，儿童中出现的糖尿病不仅是需依赖胰岛素治疗的1型糖尿病（T1DM），还有不依赖胰岛素治疗且不以糖尿病酮症酸中毒（DKA）起病的2型糖尿病（T2DM）。尽管我国的儿童T1DM发病率较低，但是人口基数大，故患儿数目不少[1]。糖尿病如未能及时救治，其产生的急性并发症如DKA会危及患儿的生命，所以需对其重视，提升对糖尿病儿童的诊治能力至关重要。

目前对儿童糖尿病的分析多来自儿童专科医院[2-3]，缺乏综合医院的数据，本研究回顾性分析本院儿科2012年1月-2019年12月收治的儿童糖尿病患儿的病历资料，对其疾病类型、发病情况进行分析，以提升对此类患者的认识，现报道如下。……