血糖及血糖波动与危重症患者预后的关系

目的:探讨危重症患者初始血糖、血糖均数、血糖标准差及血糖变异系数与其预后的关系。方法:入选86例ICU住院的危重症患者,监测其入院后48 h内的血糖值,记录初始血糖、血糖均数、血糖标准差及血糖变异系数。按预后将患者分为存活组和死亡组,比较两组间初始血糖、血糖均数、血糖标准差及血糖变异系数的差异。据血糖标准差及血糖变异系数值分为三个亚组,比较各组间的病死率。结果:死亡组初始血糖、血糖均数、血糖标准差及血糖变异系数均明显高于存活组(P<0.05或P<0.01);不同血糖标准差和血糖变异系数值分组的病死率比较,随着血糖标准差和血糖变异系数值的增高病死率也逐渐增高(P<0.0125)。结论:危重患者的血糖水平与患者的预后有关且血糖波动的范围也可能反应患者的预后。

Correlation between blood glucose,blood glucose fluctuation and prognosis of critically ill patients

Objective To explore the correlation between initial blood glucose,mean number of blood glucose,standard deviation of blood glucose,variation coefficient of blood glucose and prognosis in critically ill patients.Method Total 86 critically ill patients of ICU were choosen.We monitored blood glucose value,recorded initial blood glucose,mean number of blood glucose,standard deviation of blood glucose and variation coefficient of blood glucose.The patients were divided into the survival group and the death group according to prognosis.We compared the difference of initial blood glucose,mean number of blood glucose,standard deviation of blood glucose and variation coefficient of blood glucose between the two groups.According to standard deviation of blood glucose and variation coefficient of blood glucose,the patients were divided into three subgroups,mortality of three subgroups were compared.Results Initial blood glucose,mean number of blood glucose,standard deviation of blood glucose and variation coefficient of blood glucose of the death group were higher than those of the survival group(P<0.05 or P<0.01).When standard deviation of blood glucose and variation coefficient of blood glucose increased,mortality increased(P<0.012 5).Conclusion Blood glucose levels and blood glucose fluctuation range of critically ill patients are perhaps correlated with prognosis.