摘要
目的探讨脓肾合并应激性高血糖患者血糖变异性与肾功能及临床预后的相关性。方法将我院收治的脓肾合并应激性高血糖患者根据24h血糖波动均值(GM)及血糖波动系数(GV)四分位间距从低到高分为Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组和A组、B组、C组、D组,记录不同分组APACHEⅡ评分、肾实质厚度、肾内动脉血流阻力指数、低血糖事件及脓毒血症发生率,分析GM与GV值以及二者与APACHEⅡ评分、肾功能及脓毒症发生的相关性。结果随着GM值、GV值的升高,患者APACHEⅡ评分、RI值以及脓毒症发生率均随之升高,肾实质厚度逐渐减小,低血糖发生率无明显规律;GM值与GV值具有强相关性(P<0.01),GM值、GV值与APACHEⅡ评分、RI值呈正相关,而与肾实质厚度呈负相关,且GV值的相关性高于GM值;在控制其他因素的影响后,脓肾合并应激性高血糖患者脓毒症发生与GM值、GV值、APACHEⅡ评分、肾实质厚度、RI值存在明显的相关性(P<0.05或P<0.01)。结论脓肾合并应激性高血糖患者GM值及GV值能较好地反应患者的整体状态及肾功能,且与脓毒症发生具有明显的相关性,而与GM值相比,GV值的相关性更强,不仅对患者不良事件的发生具有一定的预测价值,而且能为后期治疗方式的选择提供一定的依据。
Objective To investigate the correlation of blood glucose variability and renal function and clinical prognosis of pyonephrosis with stress hyperglycemia patients.Methods According to the interquartile range of the 24 h blood glucose fluctuations mean（GM）and blood glucose fluctuation coefficient（GV）from low to high,the pyonephrosis with stress hyperglycemia patients of our hospital were divided into Ⅰ group,Ⅱ group,Ⅲ group,Ⅳ group and A group,B group,C group,D group.To record the APACHE Ⅱscore,renal parenchyma thickness and renal artery blood flow resistance index,hypoglycemic events and the sepsis incidence of the different groups,and analyze the correlation of GM and GV,as well as the two with APACHE Ⅱscore,renal function and the sepsis.Results With the increase of the GM and GV value,the APACHE Ⅱ score,RI values and the sepsis incidence of the patients were subsequently rise,renal parenchyma thickness were gradually reduced,the incidence of hypoglycaemia had no obvious regularity;GM value had strong correlation with GV value（P〈0.01）,GM value and GV value had positive correlation with APACHEⅡscore and RI value,and had negatively correlation with renal parenchyma thickness,and the GV value correlation was higher than the GM value;After controlling other factors influence,the sepsis occurrence of pyonephrosis with stress hyperglycemia patients had significant correlation with GM value,GV value,APACHE Ⅱ score,renal parenchyma thickness and RI value（P〈0.05 or P〈0.01）.Conclusion The GM value and GV value of pyonephrosis with stress hyperglycemia patients can preferably react the patients＇ overall condition and renal function,and has obvious correlation with sepsis,and compared with the GM value,the correlation of GV value is stronger,not only has some predicted value for the adverse events occurrence,but also can provide certain basis for the selection of treatment.
出处
《中国实验诊断学》
2016年第9期1460-1463,共4页
Chinese Journal of Laboratory Diagnosis
关键词
脓肾
应激性高血糖
血糖变异性
肾功能
预后
Pyonephrosis
Stress hyperglycemia
Blood glucose variability
Renal function
Clinical prognosis
