【摘要】 目的 探讨高血糖高渗状态(HHS)患者的心肌酶谱的变化病因及相关因素。 方法 46例糖尿病患者分为2组：HHS组24例高血糖高渗状态患者;T2DM组为22例无急性并发症的T2DM，有效血浆渗透压(POP)均低于310 mmol/L。分别监测各组的心肌酶，分析HHS组患者的心肌酶与血糖、血Na+、血UA、POP的关系。 结果 ① HHS组患者的心肌酶各指标均明显高于T2DM组患者(P<0.05，P<0.01)。②心肌酶各指标均与PoP呈正相关，肌酸激酶(CK)并与血UA呈正相关。 结论 ①HHS易于诱发横纹肌溶解症，心肌酶谱宜作为常规检查项目。②HHS时心肌酶增高主要与PoP升高程度有关。

　　【关键词】糖尿病并发症;心肌酶谱;横纹肌溶解

　　Clinical analysis on the myocardial enzyme changes of the patients in hyperglycemic hyperosmolar status GAO Hong-jiao, LI Xian-wen. Department of Endocrinology & Metabolism, Zunyi Hospital, Zunyi 563000, China

　　　【Abstract】 Objective To explore the causes and related factors of the myocardial enzyme changes of the patients in the hyperglycemic hyperosmolar status (HHS). Methods Forty-six cases of diabetes mellitus were divided into two groups: 24 HHS cases were in the HHS group and 22 T2DM cases without acute complications in the T2DM group, and the effective plasma osmolar pressure (POP) of both groups was all lower than 310mmol/L. The myocardial enzyme of each group was detected and its relation with blood glucose, blood Na+, serum uric acid (UA), and POP was analyzed. Results ①. The myocardial enzyme indices of the HHS group were significantly higher than those of the T2DM group (P<0.05, P<0.01). ②. The myocardial enzyme indices were positively related with POP and creatine kinase (CK) was positively related with serum UA. Conclusions ①. Rhabdomyolysis is likely to be induced by HHS. The myocardial enzymes, especially CK, should be monitored routinely ever since the beginning of HHS. ②. In HHS, the increase of myocardial enzyme is mainly related with the increased degree of POP.

　　【Key words】Diabetic complications; Myocardial enzyme; Rhabdomyolysis