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目的探讨综合ICU内脓毒症患者低血糖与预后的相关性。方法选择2014年1月-2016年5月入住湘雅医院重症监护病房的196例脓毒症患者,按预后分为存活组(113例)和死亡组(83例),比较两组基础临床资料以及各血糖指标差异。统计每例患者的GLU_(adm)和GLU,计算GLU_(mean)、GLU_(sd)、GLU_(max)、GLU_(min)和GLU_(dif)。按血糖最低值≤4.0 mmol/L分为低血糖组和非低血糖组,比较两组临床资料。结果死亡组低血糖发生率、GLU_(sd)、GLU_(dif)显著高于存活组;GLU_(min)显著低于存活组;低血糖组与非低血糖组APACHEⅡ评分、糖尿病史、CRRT比例、器官衰竭数目、脓毒症休克发生率存在差异;上述差异均有统计学意义(P<0.05)。APACHEⅡ评分、SOFA评分、低血糖、GLU_(sd)、器官衰竭数目、脓毒症休克是影响预后的独立危险因素(P<0.05);APACHEⅡ评分、糖尿病、器官衰竭数目是发生低血糖的独立危险因素(P<0.05)。结论脓毒症患者发生低血糖是病死率增加的独立危险因素。
Objective To investigate the relationship between hypoglycemia and prognosis in patients with sepsis in ICU. Methods A total of 196 patients with sepsis admitted to the Xiangya Hospital from January 2014 to May 2016 were divided into survival group (n = 113) and death group (n = 83) according to the prognosis. Baseline clinical data As well as the difference of each glycemic index. GLU_ (mean), GLU_ (sd), GLU_ (max), GLU_ (min) and GLU_ (dif) are calculated for each patient’s GLU_adm and GLU. According to the lowest blood glucose ≤ 4.0 mmol / L, the patients were divided into hypoglycemia group and non-hypoglycemia group. The clinical data of two groups were compared. Results The incidences of hypoglycemia, GLU_ (sd) and GLU_ (dif) in the death group were significantly higher than those in the survival group, GLU_ (min) was significantly lower than those in the survival group, APACHEⅡscore, diabetes mellitus and CRRT ratio in the hypoglycemia group and non- The number of organ failure, the incidence of septic shock differences; the above differences were statistically significant (P <0.05). APACHEⅡscore, SOFA score, hypoglycemia, GLU_ (sd), the number of organ failure, septic shock were independent risk factors affecting prognosis (P <0.05); APACHEⅡscore, diabetes and organ failure were the independent risk of developing hypoglycemia Factor (P <0.05). Conclusions Hypoglycemia in septic patients is an independent risk factor for increased mortality.