血糖变异性与急性有机磷农药中毒患者预后的关系

目的 探讨血糖变异性对急性有机磷农药中毒(AOPP)患者预后的影响。方法 选择2010年1月至2015年8月本院AOPP患者59例,按转归分为存活组(40例)和死亡组(19 例),监测记录入院72小时内血糖值,比较两组平均血糖(GLUave)、血糖标准差(GLUsd)、血糖变异率(GLUcv)、血糖不稳定指数(GLI)及急性生理与慢性健康评估Ⅱ (APACHEⅡ)评分;应用受试者工作特征曲线(ROC)对各指标预测死亡的价值进行评价。结果 两组初始血糖及GLUave比较差异无统计学意义(P>0.05)。死亡组GLUsd、GLUcv、GLI均高于存活组(P<0.05)。ROC曲线显示,GLI 预测预后的敏感性最高,与APACHEⅡ评分相似。结论 血糖变异性与AOPP患者的预后密切相关,对实施血糖控制的AOPP 患者应研究以降低血糖变异性为目标的策略以达到改善其预后。

Relationship between blood glucose variability and prognosis in patients with acute organophosphorus pesticide poisoning

Objective To investigate the relationship between blood glucose variability and prognosis in patients with acute organophosphorus pesticide poisoning (AOPP).Methods A retrospective study involving 59 patients with AOPP from January 2010 to August 2015 was performed. All cases were divided into survival group (n=40) and death group (n=19) according to the prognosis. Blood glucose (GLU), the mean and standard deviation of GLU (GLUave and GLUsd), variation of GLU (GLUcv), GLU lability index (GLI) and APACHEⅡ score were monitored and calculated. The value of prognosis of each index was evaluated by receiver operating characteristic (ROC) curve.Results There was no statistically difference in the GLU admission and GLUave between two groups (P>0.05). The levels of GLUsd,GLUcv and GLI in death group were significantly higher than those of survival group (P<0.05). ROC curve indicated that GLI was most sensitive in predicting prognosis and was similar to APACHⅡ score.Conclusion Glucose variability is firmly associated with mortality in patients with AOPP, lowering blood glucose variability is helpful in improving outcomes in AOPP patients.