CAJ | 학술논문

目的：探讨骨科住院患者糖代谢状况。方法选取2012年7月至2014年1月18岁以上的骨科成人住院患者为研究对象，入院时随机血糖≥7.0 mmol/L或空腹血糖≥5.0 mmol/L的既往未诊断糖尿病的患者，进行口服葡萄糖耐量试验（OGTT）判断糖代谢状况。各组间率的比较应用卡方检验，组间均数比较采用t检验。结果共收集有效病例1671例，骨科成人住院患者中糖尿病患病率为25.20%（416/1671），糖调节受损患病率为8.32%（139/1671）。符合行OGTT检查的患者共328例，其中新发现糖尿病133例（40.55%），糖耐量异常139例（42.37%），总糖代谢异常272例（82.92%）。按年龄分层发现，≥50岁的患者糖尿病检出率明显增高（39.39%~58.73%），差异有统计学意义（χ2=33.784，P<0.001），以60~70岁的患者最高；糖尿病患者的住院日较血糖正常的患者明显增加（t=2.294，P=0.022）。单纯测空腹血糖有47.48%的糖调节异常和60.90%的糖尿病患者被漏诊。结论骨科住院患者中约1/3合并糖代谢异常，高龄患者糖代谢异常比例更高；糖尿病患者的平均住院日高于血糖正常患者；OGTT可以减少糖代谢异常的漏诊。
목적：탐토골과주원환자당대사상황。방법선취2012년7월지2014년1월18세이상적골과성인주원환자위연구대상，입원시수궤혈당≥7.0 mmol/L혹공복혈당≥5.0 mmol/L적기왕미진단당뇨병적환자，진행구복포도당내량시험（OGTT）판단당대사상황。각조간솔적비교응용잡방검험，조간균수비교채용t검험。결과공수집유효병례1671례，골과성인주원환자중당뇨병환병솔위25.20%（416/1671），당조절수손환병솔위8.32%（139/1671）。부합행OGTT검사적환자공328례，기중신발현당뇨병133례（40.55%），당내량이상139례（42.37%），총당대사이상272례（82.92%）。안년령분층발현，≥50세적환자당뇨병검출솔명현증고（39.39%~58.73%），차이유통계학의의（χ2=33.784，P<0.001），이60~70세적환자최고；당뇨병환자적주원일교혈당정상적환자명현증가（t=2.294，P=0.022）。단순측공복혈당유47.48%적당조절이상화60.90%적당뇨병환자피루진。결론골과주원환자중약1/3합병당대사이상，고령환자당대사이상비례경고；당뇨병환자적평균주원일고우혈당정상환자；OGTT가이감소당대사이상적루진。
Objective To evaluate the glucose metabolism status of 1 671 inpatients in the Department of Orthopaedics. Methods All adult inpatients in orthopaedic department were accessed consecutively from July, 2012 to January, 2014. Oral glucose tolerance test (OGTT) was performed in patients with random blood glucose≥7.0 mmol/L or fasting plasma glucose(FPG)≥5.0 mmol/L. Chi-square test and t test were used for between-group comparison of rate and mean, respectively. Results A total of 1 671 patients were included in this study. The prevalence of diabetes mellitus (DM) and impaired glucose regulation(IGR) were 25.20%(416/1 671) and 8.32%(139/1 671), respectively. OGTT were performed in 328 patients including 133 newly-diag?nosed DM (40.55%) and 139 IGR (42.37%). The total prevalence of abnormal glucose metabolism was 33.52%. When the patients were stratified by age, the diagnosis rate of DM increased in those over 50 and the difference was statistical significant between groups(χ2=33.784, P<0.001). And the detection rate of DM reached 58.73%in 60~70 years;Compared with euglycemic patients, the hospital stay of DM was much longer (t=2.294, P=0.022). If with FPG test alone, 47.48% IGR and 60.90% DM would remain undiagnosed. Conclusion Abnormal glucose metabolism occurrs in about 1/3 orthopaedic inpatients with higher incidence observed in aged patients. Hospital stay is longer for diabetic patients. OGTT may improve screening rate of abnormal glucose metabolism.