高血糖对内科重症监护病房患者预后的影响

目的探讨高血糖对内科重症监护病房患者预后的影响。方法对2006年9月至2007年9月入住武汉大学人民医院内科重症监护病房患者共1016例的临床资料进行回顾性分析。按入院时血糖值分为糖尿病组126例、新发现高血糖组359例和血糖正常组531例，观察住院病死率、住院时间、住ICU时间、是否予以机械通气、抗生素和输血治疗情况。结果新发现高血糖组病死率22．8％（82／359），明显高于糖尿病组的12．7％（16／126）、血糖正常组的5．1％（27／531）（均P〈0．01），糖尿病组明显高于血糖正常组（P=0．002）。新发现高血糖组需要机械通气、输血、抗生素治疗的比例均较其他两组高。结论高血糖是增加内科重症监护病房患者死亡和预示预后差的重要因素，新发现高血糖患者较糖尿病组和血糖正常组患者有更高的病死率。

Impact of hyperglycemia on prognosis for patients admitted to medical intensive care units

Objective To evaluate the impact of hyperglycemia in patients admitted to medical intensive care units(MICU)on their prognosis.Methods Medical records of 1016 patients,including 126 cases of known diabetes,359 cases with newly diagnoses hyperglycemia,and 531 normoglycemic cases,admitted to MICU in Wuhan University People's Hospital during September 2006 to September 2007 were reviewed to compare their case-fatality,length of hospital stay,length of MICU stay,mechanical ventilation,blood transfusion and antibiotics use.Results In.hospital case-fatality was 22.8%(82/359)in patients with newly-diagnosed hyperglycemia.significantly higher than that in patients with known diabetes of 12.7% (16/126)and in normoglyeemic cases of 5.1%(27/531)(P＜0.01),and that Was higher in those with diabetes than those with normal blood glucose level(P=0.002).Proportions of patients who needed mechanical ventilation,blood transfusion,antibiotics use was higher in newly diagnosed hyperglycemia group than those in the other two groups.Conclusions Hyperglycemia represents an important mal'ker of poor clinical outcomes and mortality in patients admitted tO MICU.Patients with newly diagnosed hyperglycemia had a significantly higher case-fatality and poorer outcomes than those with known diabetes or normoglyeemia.