摘要
目的:探讨血糖波动对2型糖尿病合并脓毒症患者预后的影响.方法:选取2021年3月—2023年3月在湖南省某三级医院治疗的125例2型糖尿病合并脓毒症的患者,根据28 天转归结局患者是否存活,分为非存活组31例与存活组94例两组.比较两组患者的空腹血糖(FBG)、餐后两小时血糖(2hPG)、糖化血红蛋白(HbA1c)、平均血糖、血糖标准差(SDBG)、餐后血糖波动幅度(PPGE)、最大血糖波动幅度(LAGE)、血糖变异系数(CV)、葡萄糖目标范围内时间(TIR)、急性生理和慢性健康状况(APACHEⅡ)评分等指标是否存在差异;将平均血糖、SDBG、PPGE、LAGE、CV、TIR与APACHEⅡ评分进行Spearman相关性分析.结果:两组患者FBG、2hPG、HbA1c比较,差异无统计学意义;与存活组比较,非存活组患者APACHEⅡ评分、平均血糖、SDBG、PPGE、LAGE、CV均高于存活组,TIR低于存活组;平均血糖、SDBG、LAGE与APACHEⅡ评分呈正相关,TIR与APACHEⅡ评分呈负相关;CV和PPGE与APACHEⅡ评分无明显相关.结论:血糖波动与糖尿病合并脓毒症患者的预后相关,会增加不良结局的风险.
Abstract
Objective To investigate the impact of blood glucose fluctuations on the prognosis of patients with type 2 diabe-tes mellitus(T2DM)and sepsis.Methods A total of 125 patients with T2DM and sepsis who were admitted to a tertiary hospital in Hunan Province from March 2021 to March 2023 were selected.Based on the 28-day outcome,the patients were divided into two groups:the non-survival group(n=31)and the survival group(n=94).fasting blood glucose(FBG),postprandial blood glucose at 2 hours(2hPG),glycated hemoglobin(HbA1c),mean blood glucose,blood glucose standard deviation(SDBG),post-prandial blood glucose fluctuation amplitude(PPGE),maximum blood glucose fluctuation amplitude(LAGE),blood glucose co-efficient of variation(CV),time in range(TIR),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,and other indicators were collected.The differences between the two groups were compared for statistical significance.Spearman correla-tion analysis was performed between mean blood glucose,SDBG,PPGE,LAGE,CV,TIR and APACHE Ⅱ score.Results The FBG,2hPG,and HbA1c levels were no significant difference between the two groups;Compared with the survival group,the non-survival group had higher APACHE Ⅱ scores,mean blood glucose,SDBG,PPGE,LAGE,and CV,but lower TIR.There were significant differences between the two groups;Mean blood glucose,SDBG,and LAGE were positively correlated with APACHE Ⅱ scores,while TIR was negatively correlated with APACHE Ⅱ scores.There was statistical significance.CV and PPGE were not significantly correlated with APACHE Ⅱ scores.Conclusion Blood glucose fluctuations are associated with the prognosis of patients with diabetes mellitus and sepsis,increasing the risk of adverse outcomes.
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