The early warning significance of cytokines in children with type 1 diabetic ketoacidosis complicated with cerebral edema
Description
Abstract Objective To explore the clinical significance of cytokines in children with type 1 diabetic ketoacidosis complicated with cerebral edema, and to provide early warning indicators for type 1 diabetic ketoacidosis complicated with cerebral edema. Methods A total of 73 children with diabetic ketoacidosis ( DKA ) aged 1-15 years old who were hospitalized in the Department of Endocrinology from January 2017 to January 2022 were selected, including 48 children in the simple DKA group and 25 children in the DKACE group. The blood gas analysis, electrolyte, white blood cell count on admission, C-reactive protein, interleukin-1, interleukin-2, interleukin-4, interleukin-6, interleukin-8, interleukin-10, tumor necrosis factor-α, interferon-γ, interleukin-2 receptor were compared between the two groups, and the differences between the two groups were analyzed. Results The results of univariate analysis showed that the levels of IL-2, IL-4, IL-6, IL-10, TNF-α, IL-2R, blood glucose, urea nitrogen and serum creatinine in DKACE group were higher than those in DKA group ( P <0.05 ) and higher than those in DKA group ( P < 0.05 ), and the PH value,PaCO2, HCO3-and K + were lower than those in DKA group ( P < 0.05 ). ROC curve analysis showed that the area under the curve of IL-4 combined with blood glucose detection was 0.908, and the combination of the two detection indexes could improve the sensitivity or specificity compared with the single detection index. The sensitivity of IL-6 combined with blood glucose detection for DKACE was 96 %, and the specificity was 87.5 %. Conclusion ( 1 ) Blood glucose, PH value, HCO3-, urea nitrogen, serum creatinine, IL-2, IL-4, IL-6, IL-10, TNF-α, IL-2R can be used as early warning indicators of DKACE. ( 2 ) The combination of the two detection indicators can improve the sensitivity or specificity compared with the single detection index, and provide the basis for the early identification and early treatment of DKACE.