CK.... Figure 1. 全症例における血清 CK 値と血糖値の関係 B. 方法 CK - mu/ml CK CK-MB CK BMI body mass index HbA c GOT GPT LDH-GTP CRP HDL- LDL- BUN egfr Na K Cl Ca P Pos

Size: px

Start display at page:

Download "CK.... Figure 1. 全症例における血清 CK 値と血糖値の関係 B. 方法 CK - mu/ml CK CK-MB CK BMI body mass index HbA c GOT GPT LDH-GTP CRP HDL- LDL- BUN egfr Na K Cl Ca P Pos"

みいかかいじ
7 years ago
Views:

1 原著論文 CK 佐々木正美, 山田穂高, 浅野智子, 青木厚, 生駒亜希, 豊島秀男, 加計正文, 川上正舒, 石川三衛要約 CK CK CK, U/L CK HDL.. vs..., P=. Ca.. vs... mg/dl, P=.,.. vs... mg/dl, P=. CK I. 緒言 CK CK CK CK Ⅱ. 目的 Ⅲ. 対象と方法 A. 対象..

2 CK.... Figure 1. 全症例における血清 CK 値と血糖値の関係 B. 方法 CK - mu/ml CK CK-MB CK BMI body mass index HbA c GOT GPT LDH-GTP CRP HDL- LDL- BUN egfr Na K Cl Ca P Posm ph Base excess Ca + Ht egfr Ⅳ. 統計 Student SPSS version.. Ⅴ. 結果 A. 血清 CK 高値例の臨床像 CK,, ~,mu/ml CK Figure P=. B. 血清 CK 値高値例と非高値例の比較 ADA CK CK, mu/ ml CK, mu/ml CK CK.. vs... mu/ ml, P=... vs... P. Table CK.. vs... mg/dl, P=. GPT.. vs... mu/ml, P=. LDH.. vs... mu/ml, P=. HDL.. vs..., P=. Table egfr CK + CK +

3 CK Na mmol/l Na Ca.. vs... mg/dl, P=. ph Table Table 1. 血清 CK 高値例と非高値例の臨床像 Table 1. の比較 CK CK 2000mU/ml(N=3) CK 2000mU/ml(N=22) P CK (mu/ml) CK (mu/ml) ( ) <0.001 BMI (kg/ ) ( ) ( ) / 3 10 / 22 (12 ) (1512 ) 7 / 22(14 ) 5 / 22 Ht ( ) ( ) 100 Table 2. 血清 CK 高値例と非高値例の検査値の比較 1 Table 3. 血清 CK 高値例と非高値例の検査値 Table 3. の比較 2 CK CK 2000mU/ml(N=3) CK 2000mU/ml(N=22) P (mg/dl) (mg/dl) egfr (ml/min./1.73m2) / 3 3 / Na (mmol/l) Na (mmol/l) K (mmol/l) Cl (mmol/l) Ca (mg/dl) P (mg/dl) (mmol/kg) ph (mmol/l) Ca 2+ (mmol/l) Na Ca C. 臨床経過 CK CK CK CK Table Table 4. 血清 CK 高値例 3 例の臨床像及び経過 Cr HbA1c CK BMI ( ) (JDS ) CK ( ) (kg/ ) (mg/dl) (mg/dl) (% CK 2000mU/ml(N=3) CK 2000mU/ml(N=22) P 32 2 ( ) (7770) (0.64) HbA1c (, JDS ) (mg/dl) (4455) (0.91) GOT (mu/ml) GPT (mu/ml) LDH (mu/ml) -GTP (mu/ml) (10805) (0.72) (mu/ml) CRP (mg/dl) (mg/dl) (mg/dl) HDL (mg/dl) LDL (mg/dl) CK CK HDL CK

4 CK CK Table Table 5. 血小板数 HDL コレステロールの推移 CK 2000mU/ml(N=3) CK 2000mU/ml(N=22) P value ( 10 4 l) CK ( 10 4 l) ( 10 4 l) ( 10 4 l) (%) ( ) ( ) 100 CK 2000mU/ml(N=3) CK 2000mU/ml(N=22) P value HDL (mg/dl) (mg/dl) (%) <0.001 ( ) ( ) 100 Ⅵ. 考察 CK GPT LDH HDL Ca CK CK Schlepphorst Wang Na mg/dl Na CK ADA CK CK mu/ml ADA mu/ml mu/ml Wang CRRT continuous renal replacement therapy: DIC

5 CK / l HDL HDL CK CK Adler Na Korzets Na Na + Ca + Ca + Na Ca Na Na CK Na Na Na Na Na Na Na CK Ⅶ. 結語 CK jds//.html 文献 Wa n g L M, Ts a i S T, H o LT, e t a l. Rhabdomyolysis in diabetic emergencies. Diabetes Res Clin Pract : -,. M a t s u o S, I m a i E, H o r i o M, e t a l : Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum

6 CK creatinine in Japan. Am J Kidney Dis : -,. American Diabetes Association. Standards of medical care in diabetes--. Diabetes Care Suppl : S-,. DKA RM Suppl :,. Casteels K, Beckers D, Wouters C et al: Rhabdmyolysis in diabetic ketoacidosis. Pediatric Diabetes : -,. Schlepphorst E, Levin ME: Rhabdomyolysis associated with hyperosmolar nonketotic coma. Diabetes Care : -,. -,. MRSA -,. mg/dl, DIC -,. Singhal PC, Abramovici M, Ayer S et al: Determinants of rhabdomyolysis in the diabetic state. Am J Nephrol. : -,. Leung CB, Li PK, Lui SF, et al: Acute renal failure ARF caused by rhabdomyolysis due to diabetic hyperosmolar nonketotic coma: a case report and literature review. Ren Fail : -,. Weidman SW, Ragland JB, Fisher JN Jr, et al: Effects of insulin on plasma lipoproteins in diabetic ketoacidosis: evidence for a change in high density lipoprotein composition during treatment. J Lipid Res : -,. Adler S: Hyponatremia and rhabdomyolysis, a possible relationship. South Med J : -,. Korzets A, Ori Y, Floro S, et al: Case report: severe hyponatremia after water intoxication: a potential cause of rhabdomyolysis. Am J Med Sci : -,. Sasaki M, Yuzawa M, Saito T, et al: Clinical and laboratory features of hyponatremiainduced myopathy. Clin Exp Nephrol : -,. Robinson AG, Verbalis JG.: The syndrome of inappropriate antidiuretic hormone secretion In: Williams Text of Endocrinology ed, eds Kronenberg H, Larsen PR, Melmed S, Polonsky K, Elsevier, Philadelphia,, pp.

7 Jichi Medical University Journal Rhabdomyolysis closely associated with diabetic ketoacidosis Masami Sasaki, Hodaka Yamada, Tomoko Asano, Atsushi Aoki, Aki Ikoma, Hideo Toyoshima, Masafumi Kakei, Masanobu Kawakami, Sane Ishikawa Abstract Background: The present study was undertaken to determine the clinical and laboratory features of diabetic ketoacidosis with rhabdomyolysis. Methods: We recruited patients with diabetic ketoacidosis over a -years period, including males and females aged.. years (means SD) ranging from to years. Fourteen patients had type diabetes and had type diabetes. The patients were divided into two groups according to their peak serum creatine kinase (CK) levels: a high serum CK level group (patients with serum CK levels over IU/ml) and a normal CK level group (patients with serum CK levels under IU/ml). Results: There were diabetic ketoacidosis patients with an elevated serum CK level over IU/ ml; all were young males without a diagnosis of diabetes mellitus. There were significant differences between a high serum CK level group and a normal CK level group in plasma glucose levels (,.. vs... mg/dl, P =. ), serum HDL (high density lipoprotein) cholesterol levels (.. vs..., P =. ) and serum Ca levels (.. vs... mg/dl, P =. ) at admission. Serum CK levels normalized within days after hospitalization in all patients without renal impairment. Conclusion: The present findings indicate that rhabdomyolysis could be complicated by diabetic ketoacidosis. In particular, a rapid onset of hyperglycemia may cause rhabdomyolysis and associate renal impairments. Department of endocrinology and metabolism, Jichi Medical University Saitama Medical Center

sick contact1l

Clinical Question 2017 年 5 月 15 日分野 : 内分泌テーマ : 治療 19 14 15 18 sick contact1l 170cm/68.8kg, GCSE1V1M5, HR: 120/min, BP: 104/60mmHg, RR: 30/min, SpO 2 : 96%, BT: 38.0 WBC Hb PLT CRP Cr BUN 23400 15.0 35.5

CK.... Figure 1. 全症例における血清 CK 値と血糖 値の関係 B. 方法 CK - mu/ml CK CK-MB CK BMI body mass index HbA c GOT GPT LDH-GTP CRP HDL- LDL- BUN egfr Na K Cl Ca P Pos

CK.... Figure 1. 全症例における血清 CK 値と血糖値の関係 B. 方法 CK - mu/ml CK CK-MB CK BMI body mass index HbA c GOT GPT LDH-GTP CRP HDL- LDL- BUN egfr Na K Cl Ca P Pos