摘要
目的探讨综合ICU内脓毒症患者低血糖与预后的相关性。方法选择2014年1月-2016年5月入住湘雅医院重症监护病房的196例脓毒症患者,按预后分为存活组(113例)和死亡组(83例),比较两组基础临床资料以及各血糖指标差异。统计每例患者的GLU_(adm)和GLU,计算GLU_(mean)、GLU_(sd)、GLU_(max)、GLU_(min)和GLU_(dif)。按血糖最低值≤4.0 mmol/L分为低血糖组和非低血糖组,比较两组临床资料。结果死亡组低血糖发生率、GLU_(sd)、GLU_(dif)显著高于存活组;GLU_(min)显著低于存活组;低血糖组与非低血糖组APACHEⅡ评分、糖尿病史、CRRT比例、器官衰竭数目、脓毒症休克发生率存在差异;上述差异均有统计学意义(P<0.05)。APACHEⅡ评分、SOFA评分、低血糖、GLU_(sd)、器官衰竭数目、脓毒症休克是影响预后的独立危险因素(P<0.05);APACHEⅡ评分、糖尿病、器官衰竭数目是发生低血糖的独立危险因素(P<0.05)。结论脓毒症患者发生低血糖是病死率增加的独立危险因素。
Objective To investigate the relationship of hypoglycemia with prognosis in sepsis patients of ICU. Methods 196 patients with sepsis admitted into our intensive care unit（ ICU） from January 2014 to April 2016 were grouped as the survival group（ 113） and the death group（ 83） in our study. The clinical data of two groups were compared. The blood glucose concentration（ GLU）,the blood glucose concentration on admission（ GLU（adm）） of each patient were statistically counted,and GLU（mean）,GLU（sd）,GLU（max）,GLU（min）and GLU（dif）were counted. The patients were divided into hypoglycemia group and no-hypoglycemia group according to if the GLU（min）was less than or equal to 4. 0 mmol/L. Results Hypoglycemia,GLU（dif）,GLU（sd）in death group were significantly higher than those in surival group,GLU（min）in death group was significantly lower than those in surival group.There was statistical significance on the difference in APACHEⅡ score,diabetes history,CRRT,septic shock and organ failure between the hypoglycemia group and no-hypoglycemia group（ P〈0. 05）. Logistic regression analysis showed that APACHEⅡscore,SOFA score,diabetes history,GLU（sd）,organ failure,septic shock and hypoglycemia were independent risk factors of prognosis（ P〈0. 05）. APACHEⅡscore,diabetes history and organ failure were independent risk factors of hypoglycemia（ P〈0. 05）. Conclusion Hypoglycemia played an important role in increasing the mortality.
出处
《中国卫生检验杂志》
CAS
2017年第6期842-844,847,共4页
Chinese Journal of Health Laboratory Technology
关键词
脓毒症
低血糖
血糖变异度
预后
Sepsis
Hypoglycemia
Glucose variability
Prognosis
