1671例骨科住院患者糖代谢状况调查
Survey on glucose metabolism in 1 671 cases of orthopaedic inpatients
孙璐 1苏晓飞 1陶小军 1丁波 1胡蕴 1李铮 1江冰 1韦忠培 1马建华1
作者信息
- 1. 210006 南京医科大学附属南京医院 南京市第一医院 内分泌科
- 折叠
摘要
目的:探讨骨科住院患者糖代谢状况。方法选取2012年7月至2014年1月18岁以上的骨科成人住院患者为研究对象,入院时随机血糖≥7.0 mmol/L或空腹血糖≥5.0 mmol/L的既往未诊断糖尿病的患者,进行口服葡萄糖耐量试验(OGTT)判断糖代谢状况。各组间率的比较应用卡方检验,组间均数比较采用t检验。结果共收集有效病例1671例,骨科成人住院患者中糖尿病患病率为25.20%(416/1671),糖调节受损患病率为8.32%(139/1671)。符合行OGTT检查的患者共328例,其中新发现糖尿病133例(40.55%),糖耐量异常139例(42.37%),总糖代谢异常272例(82.92%)。按年龄分层发现,≥50岁的患者糖尿病检出率明显增高(39.39%~58.73%),差异有统计学意义(χ2=33.784,P<0.001),以60~70岁的患者最高;糖尿病患者的住院日较血糖正常的患者明显增加(t=2.294,P=0.022)。单纯测空腹血糖有47.48%的糖调节异常和60.90%的糖尿病患者被漏诊。结论骨科住院患者中约1/3合并糖代谢异常,高龄患者糖代谢异常比例更高;糖尿病患者的平均住院日高于血糖正常患者;OGTT可以减少糖代谢异常的漏诊。
Abstract
Objective To evaluate the glucose metabolism status of 1 671 inpatients in the Department of Orthopaedics. Methods All adult inpatients in orthopaedic department were accessed consecutively from July, 2012 to January, 2014. Oral glucose tolerance test (OGTT) was performed in patients with random blood glucose≥7.0 mmol/L or fasting plasma glucose(FPG)≥5.0 mmol/L. Chi-square test and t test were used for between-group comparison of rate and mean, respectively. Results A total of 1 671 patients were included in this study. The prevalence of diabetes mellitus (DM) and impaired glucose regulation(IGR) were 25.20%(416/1 671) and 8.32%(139/1 671), respectively. OGTT were performed in 328 patients including 133 newly-diag?nosed DM (40.55%) and 139 IGR (42.37%). The total prevalence of abnormal glucose metabolism was 33.52%. When the patients were stratified by age, the diagnosis rate of DM increased in those over 50 and the difference was statistical significant between groups(χ2=33.784, P<0.001). And the detection rate of DM reached 58.73%in 60~70 years;Compared with euglycemic patients, the hospital stay of DM was much longer (t=2.294, P=0.022). If with FPG test alone, 47.48% IGR and 60.90% DM would remain undiagnosed. Conclusion Abnormal glucose metabolism occurrs in about 1/3 orthopaedic inpatients with higher incidence observed in aged patients. Hospital stay is longer for diabetic patients. OGTT may improve screening rate of abnormal glucose metabolism.
关键词
糖尿病/糖调节受损/口服糖耐量试验/骨科住院患者Key words
Diabetes mellitus/Impaired glucose regulation/Oral glucose tolerance test/Orthopaedics inpatients引用本文复制引用
基金项目
江苏省科技发展计划项目(BL2014010)
出版年
2015