Urinary ketone body is the general name of three different components. They areacetone、Acetoacetic acidandβ - hydroxybutyric acid, they are internalFat metabolismOfIntermediate product。Under normal circumstances, there is very little ketone body, which cannot be detected by our current routine methods, so the qualitative test of ketone body in normal people is negative.But in the case of hungerCarbohydrate metabolismIn case of increased dyslipidemia and diabetic acidosis, the speed of ketone body production is faster than that of tissue utilizationKetosis, thenKetonuriaAt this time, the situation is not optimistic. You should go to the hospital in time to avoid unnecessary injuries.
（1）Diabetic ketoacidosis: It is caused by the decrease of sugar utilization and the increase of ketone body produced by decomposing fatKetosis。Occurrence of uncontrolled or improperly treated diabetesAcidosisOr in a coma,Urine ketone body examinationVery valuable.Should be connected withhypoglycemiaHeart and brain diseaseslactic acidPoisoning orhyperglycemiahighPermeabilityDiabetic comaIs different.ketoacidosisWhen the urine ketone body is positive, the latter generally does not increase, but attention should be paid to diabetic ketosisrenal functionWhen the renal threshold is increased due to severe injury, the urinary ketone body can also be reduced, or even completely disappeared.
(2) Non diabetic ketosis: such as infectious disease pneumoniaTyphoid fever、septicemia、Tuberculosisetc.feverStage, severe diarrhea, vomiting, hunger, long fasting, and general numbness can occurKetonuria, which is quite common.Common causes of pregnant womenPregnancy reaction, vomiting, eating less, so thatBody fatDecreased catabolism increased significantlyKetosisIt may cause ketonuria.
Urinary ketone bodyQualitative experiment, often associated with diabetes, pregnancyinnutrition、chronic diseaseofGenerally, it is expressed by the number of "plus sign", but the results of instrument measurement are commonly usedSemiquantitativeSee the table for the relationship between "plus sign" and semi quantitative expression results.
Table Relationship between plus sign and ketone body content
Plus sign method mg/dL (mg/dl) mmol/L (mmol/L)
Trace 5 0.5
+ 151.5
+ + 40 3.9
+ + + 80 7.8
+ + + + 160 15.6
Ketone body positive
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Ketone body positive
1．diabetesPatients and diabetics with acidosis may have strong positive (+++or above). Attention should be paid at this time. Toxic coma is likely to occur, and timely measures should be takenTreatment measures。
When your body can't useglucoseAs a source of energyLipolysisIt generates energy, and then there will be a kind of ketone bodyAcidsIf the ketone body accumulates too much in the body, it will cause serious consequences, even coma.Therefore, patients with diabetes, especially type 1 diabetes, should be able toSelf monitoringUrine ketone body, so as to timely detect excessive ketone body accumulation in the body.
Urinary ketone bodies shall be determined under the following conditions:
Please measure urinary ketone body by yourself when the following conditions occur: blood sugar exceeds 240 mg/dl;Stop treatment for various reasons;Cold or discomfort;suffer fromInfectivityDisease;Vomiting or stomach discomfort before and after operation;Pregnancy is extremely stressful.
*Determination method? Test paper method can be used for self-test of urine ketone body:
Insert the test paper into the urine sample.
Wait for a few seconds according to the instructions.
① Because acetone and acetoacetic acid in urine ketone body havevolatilityAcetoacetic acid is easier to decompose into acetone when heated;After the urine is contaminated by bacteria, the ketone body disappears, so the urine must be fresh and submitted for inspection in time to avoid false results due to the volatilization or decomposition of ketone bodyNegative resultsOr the result is low;
② The sensitivity of dry method and ketone powder method is different: the sensitivity of ketone powder method to acetoacetic acid and acetone is 80mg/L and 100mg/L respectively.The test strip method is not as sensitive as the test strip method, so two methods of the same pathological specimen may have different results,Analysis resultsSpecial attention shall be paid to;
③ Caused by different causesKetosisThe composition of ketone body is different, even if a patient has different disease course, for exampleDiabetic ketoacidosisIn the naming of early diseases, the main ketone body componentshydroxybutyric acid There is little or lack of acetoacetic acid, and the measured results can lead to an underestimation of the total ketone volume.After the symptoms of diabetic ketoacidosis are alleviated, β - hydroxybutyric acid is converted to acetoacetic acid, which in turn makes acetoacetic acidContent ratioinitialacute stageincrease,EasinessThe condition is estimated to be too serious.Therefore, the inspector must pay attention to the development of the disease course, andclinicianAnalyze the experimental results together.
