尿液中的酮：何时以及为什么测试它们以及它们的含义

In people with diabetes, high levels of ketones in the urine can indicate a serious complication called diabetic ketoacidosis. But excess ketones can also accompany other health problems.

Your body typically uses glucose, or sugar, as its main source of energy. When cells don’t get the glucose they need, the body begins to use fat instead. Burning fat produces ketones, a type of acid that ends up in your blood and urine that can make you very sick.

Doctors regularly test for ketones in the urine of people with type 1 and type 2 diabetes, though ketones are more common amongpeople with type 1 diabetes。如果您患有糖尿病，并且尿液中有更高水平的酮，那么您的身体没有得到胰岛素的胰岛素，它需要将糖从血液转移到细胞以用作能量。（（1)这可能导致高血糖, or高血糖，这可能导致严重的并发症，例如心脏病，中风，视力问题和神经损伤，如果无法正确管理。

是什么导致尿液中高水平的酮？

For people with diabetes, high levels of ketones in urine can be caused by illness, missing aninsulin shot，一种无效的胰岛素泵，无法获得足够的胰岛素或接受变质的胰岛素。（（2)It can also occur when a person has missed a meal or has not eaten enough. (3)

In addition to diabetes, you may also be at risk for ketones in urine if you have or experience the following: (4)

• 怀孕
• Eating disorder
• Strenuous exercise
• 慢性呕吐或腹泻
• 吃低碳水化合物饮食
• Pneumonia
• Alcohol abuse
• 感染
• Heart attack
• Stroke
• Fasting
• High fever
• Sepsis
• 烧伤
• Hyperthyroidism
• Nursing a baby without proper nutrition

A test to detect ketones in urine can be administered at home or in a lab. Sometimes patients are asked not to eat or drink for a specified amount of time before they take the test.

When testing in a lab, patients are advised to wash their hands and then clean their genital area via a sterilecleansingpad. Patients must then collect 1 to 2 ounces of urine into a container, and give the sample to the appropriate healthcare provider. (1)

患者还可以通过进行尿液测试条进行现场测试来测试家里尿液中的酮。您可以在干净的容器中捕获尿液，然后将测试条浸入容器中，也可以直接在测试条上排尿。按照说明查看测试后多长时间您应该阅读条带的颜色。然后将带状颜色与瓶子上的颜色图进行比较。（（5)

If you are testing for ketones in babies or toddlers who wear diapers, clean cotton wool can also be used to capture urine. (5)

在测试酮的尿液时，重要的是要确保测试条未过期。

您不需要处方即可从当地药房获取酮测试套件。与您的医生谈谈哪种测试套件最适合您并提供最相关的信息。

尿液测试中酮的结果可能与特定数字有所不同，或者定性地分类为小，中等或大量的酮。认为尿液中正常数量的酮会因年龄，性别，健康史和其他因素而异，因此请务必与您的医生谈论您的运动和饮食习惯, as well as other factors that might affect your typical level. (1)

当我应该有一个测试在尿酮吗?

如果您患有糖尿病或其他疾病，使您有高水平酮的风险，当您遇到以下任何一种时，医疗保健提供者通常建议您每4至6小时测试一次酮：（（6)

• 血糖level above 240 milligrams per deciliter (mg/dl)
• 呕吐和恶心的感觉
• 腹痛
• 其他疾病，例如cold or flu
• 持续的疲劳
• 干口或持续口渴
• Flushed skin
• Fruity-smelling breath
• 混乱

如果您的孩子患有糖尿病并生病，他或她将需要额外的关注并与医生进行咨询。如果孩子发烧，呕吐或腹泻，请立即通知孩子的糖尿病团队。如果您的孩子的尿液测试对酮的阳性，也请与医生联系。（5）

What Does an Abnormal Result for a Ketones in Urine Test Mean?

异常结果通常如下分解：（4）

• 小：20 mg/dl
• Moderate: 30 to 40 mg/dl
• Large: >80 mg/d

尿液中的少量酮可以正常，特别是如果一个人试图减肥和maintains healthy blood sugar levels. People with diabetes who are trying to lose weight should make sure they monitor their blood sugar and ketone levels closely. (2)

If you test for ketones in your urine and the results indicate a small amount, consult with your doctor and continue retesting every few hours. (6)

If test results show moderate or large amounts of ketones in urine, contact your healthcare provider immediately. It’s also important not to exercise when ketone levels are high or when your blood sugar is high, as this can worsen effects. (6)

If test results show high levels of ketones in your urine, your doctor may check the amount of ketones in your blood and also conduct the following urine tests: (7)

• 血糖
• 蛋白质
• pH (or acid level)

When Can Ketones in Urine Be a Sign of Ketoacidosis?

High levels of ketones detected in your urine are a potential indicator ofdiabetic ketoacidosis（（DKA), a severecomplication of diabetes。糖尿病酮症酸中毒通常是一个人在诊断出糖尿病的第一个迹象。（2）

如果您生病并患有糖尿病，您的血糖和酮水平可能会升高并引起酮症酸中毒。请咨询您的医疗保健提供者，以了解如何监测酮和血糖水平以及生病时如何预防酮症酸中毒。（2）

酮症酸中毒的其他症状可能包括：（1）

• 呼吸困难
• Nausea
• 呕吐
• 联合国usual thirst
• Fruity-smelling breath
• Flushed skin
• 腹痛
• 混乱
• 嗜睡
• 无意识

It’s important to seek help for DKA immediately, as it can lead to adiabetic coma甚至死亡。（3）