中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2015年
1期
41-44
,共4页
王爱民%熊晓琴%叶洪江%徐向进%翁小翠%何小琼
王愛民%熊曉琴%葉洪江%徐嚮進%翁小翠%何小瓊
왕애민%웅효금%협홍강%서향진%옹소취%하소경
动态血糖监测%急性病生理学和长期健康评价%重症监护%预后
動態血糖鑑測%急性病生理學和長期健康評價%重癥鑑護%預後
동태혈당감측%급성병생이학화장기건강평개%중증감호%예후
Dynamic blood glucose monitoring%Acute physiology and chronic health evaluation%Intensive care%Prognosis
目的 探讨重症监护病房(ICU)危重症患者早期(24 h内)血糖情况对患者转归的影响.方法 选择2012年3月至2013年3月入住我院ICU的104例患者,入科24 h内进行急性生理学及慢性健康状况评分系统(APACHEⅡ)评分和动态血糖监测.对死亡组和存活组低血糖总时间、正常血糖总时间、高血糖总时间及APACHEⅡ评分进行比较,将有统计学差异的血糖指标按四分位数间距将患者分为G1(P0-P25) 、G2(P25-P50)、G3(P50-P75)、G4(P75-P100)四个亚组,采用方差分析和卡方检验的方法来评估随着血糖情况、APACHEⅡ评分、死亡率的变化.结果 死亡组中APACHEⅡ值[(32.5±7.6)分]、低血糖时间窗[2.29(0～ 7.68)分]、高血糖时间窗[14.3(3.36～ 24.00)分]均明显高于存活组[(19.9±6.5)分、0.41(0～ 2.88)、3.8(0～12.96)h],两组差异均有统计学意义(t=5.65、Z=-2.01,-3.01,均P＜0.05),死亡组的正常血糖时间窗[7.41(0.24～ 17.52)h]明显低于存活组[19.79(11.28～ 24.00)h],两组差异有统计学意义(Z=-3.95,P＜0.01).亚组分析显示,随着正常血糖时间窗的增加,危重症患者APACHEⅡ分值呈逐渐下降趋势(F=32.20,P＜0.01);随着高血糖时间窗的增加,危重症患者APACHEⅡ分值呈逐渐升高趋势(F=18.71,P＜0.01);低血糖时间窗的比较分析显示,是否发生低血糖,患者APACHEⅡ评分差异无统计学意义(t=-l.3,P＞0.05).结论 危重症患者早期正常血糖时间窗越长,危重症患者的转归越好,高血糖时间窗越长则患者预后出现变差趋势.
目的 探討重癥鑑護病房(ICU)危重癥患者早期(24 h內)血糖情況對患者轉歸的影響.方法 選擇2012年3月至2013年3月入住我院ICU的104例患者,入科24 h內進行急性生理學及慢性健康狀況評分繫統(APACHEⅡ)評分和動態血糖鑑測.對死亡組和存活組低血糖總時間、正常血糖總時間、高血糖總時間及APACHEⅡ評分進行比較,將有統計學差異的血糖指標按四分位數間距將患者分為G1(P0-P25) 、G2(P25-P50)、G3(P50-P75)、G4(P75-P100)四箇亞組,採用方差分析和卡方檢驗的方法來評估隨著血糖情況、APACHEⅡ評分、死亡率的變化.結果 死亡組中APACHEⅡ值[(32.5±7.6)分]、低血糖時間窗[2.29(0～ 7.68)分]、高血糖時間窗[14.3(3.36～ 24.00)分]均明顯高于存活組[(19.9±6.5)分、0.41(0～ 2.88)、3.8(0～12.96)h],兩組差異均有統計學意義(t=5.65、Z=-2.01,-3.01,均P＜0.05),死亡組的正常血糖時間窗[7.41(0.24～ 17.52)h]明顯低于存活組[19.79(11.28～ 24.00)h],兩組差異有統計學意義(Z=-3.95,P＜0.01).亞組分析顯示,隨著正常血糖時間窗的增加,危重癥患者APACHEⅡ分值呈逐漸下降趨勢(F=32.20,P＜0.01);隨著高血糖時間窗的增加,危重癥患者APACHEⅡ分值呈逐漸升高趨勢(F=18.71,P＜0.01);低血糖時間窗的比較分析顯示,是否髮生低血糖,患者APACHEⅡ評分差異無統計學意義(t=-l.3,P＞0.05).結論 危重癥患者早期正常血糖時間窗越長,危重癥患者的轉歸越好,高血糖時間窗越長則患者預後齣現變差趨勢.
목적 탐토중증감호병방(ICU)위중증환자조기(24 h내)혈당정황대환자전귀적영향.방법 선택2012년3월지2013년3월입주아원ICU적104례환자,입과24 h내진행급성생이학급만성건강상황평분계통(APACHEⅡ)평분화동태혈당감측.대사망조화존활조저혈당총시간、정상혈당총시간、고혈당총시간급APACHEⅡ평분진행비교,장유통계학차이적혈당지표안사분위수간거장환자분위G1(P0-P25) 、G2(P25-P50)、G3(P50-P75)、G4(P75-P100)사개아조,채용방차분석화잡방검험적방법래평고수착혈당정황、APACHEⅡ평분、사망솔적변화.결과 사망조중APACHEⅡ치[(32.5±7.6)분]、저혈당시간창[2.29(0～ 7.68)분]、고혈당시간창[14.3(3.36～ 24.00)분]균명현고우존활조[(19.9±6.5)분、0.41(0～ 2.88)、3.8(0～12.96)h],량조차이균유통계학의의(t=5.65、Z=-2.01,-3.01,균P＜0.05),사망조적정상혈당시간창[7.41(0.24～ 17.52)h]명현저우존활조[19.79(11.28～ 24.00)h],량조차이유통계학의의(Z=-3.95,P＜0.01).아조분석현시,수착정상혈당시간창적증가,위중증환자APACHEⅡ분치정축점하강추세(F=32.20,P＜0.01);수착고혈당시간창적증가,위중증환자APACHEⅡ분치정축점승고추세(F=18.71,P＜0.01);저혈당시간창적비교분석현시,시부발생저혈당,환자APACHEⅡ평분차이무통계학의의(t=-l.3,P＞0.05).결론 위중증환자조기정상혈당시간창월장,위중증환자적전귀월호,고혈당시간창월장칙환자예후출현변차추세.
Objective To explore the impact of initial dynamic blood glucose on the prognosis of critically ill patients in intensive care unit(ICU) in the first 24 hours.Methods Totally 104 critically ill patients were selected from March 2012 to March 2013.The dynamic blood glucose was monitored and acute physiology and chronic health evaluation(APACHE Ⅱ) scores were collected in the first 24 hours in ICU.Four subgroups were further divided by the results of hypoglycemia time windows,hyperglycemia time windows,euglycemia time windows and APACHE Ⅱ scores[G1(P0-P2,),G2(P25-P50),G3(P50-P75),G4(P75-P100)].Variance and Chi-square test were used to analyze and compare the changes of APACHE Ⅱ scores and rate of mortality.Results The APACHE Ⅱ scores in death group(32.5±7.6) was significantly higher than that in survival group(19.9±6.5),the hypoglycemia time windows (2.29(0-7.68)h) and hyperglycemia time windows (14.3(3.36-24.00)h) in death group were significantly longer than those in the survival group(0.41 (0-2.88),3.8 (0-12.96)h),and the euglycemia time windows (7.41 (0.24-17.52)h) in death group was significantly shorter than that in the survival group(19.79(11.28-24.00)h,t=5.65,Z=-2.01,-3.01,-3.95,all P＜0.05).Hyperglycemia time windows were positively correlated with APACHE Ⅱ scores,meanwhile,euglycemia time windows were found to be negatively correlated with APACHE Ⅱ scores (F=18.71,32.20,both P＜0.01).There was no significant difference in APACHE Ⅱ scores between patients developed hypoglycemia and did not(t=-1.3,P＞0.05).Conclusion The euglycemia time windows is positively correlated with the prognosis of patients in ICU,and hyperglycemia time windows is negatively correlated with the prognosis of the patients.The initial dynamic blood glucose time window plays an important role in predicting the progress and prognosis of severe disease.
