血渗透压可独立预测糖尿病高血糖急症的死亡风险  

Serum osmolarity independently predicts risk of death of hyperglycaemic emergencies in diabetes mellitus

作　　者：赵莉莉[1] 李秋云[1] 郭菊秋[2] 徐乃跃[1] 史丽萍[1] 樊继援[3] 

机构地区：[1]华北煤炭医学院附属开滦医院内分泌科,河北唐山063000 [2]河北省唐山市古冶区医院内科,河北唐山063103 [3]天津医科大学总医院内分泌科,天津300052

出　　处：《中国现代医学杂志》2011年第22期2777-2779,2782,共4页China Journal of Modern Medicine

摘　　要：目的检测糖尿病性酮症酸中毒(DKA)和(或)高渗状态(HHS)的高血糖急症(HEs)患者的临床特征和预后因素。方法对1999～2009年住开滦医院的64例患者进行回顾性分析。结果受试者中DKA、DKA-HHS和HHS的构成比分别为57.8%、23.4%和18.8%。DKA([58±12)岁]、DKA-HHS([64±16)岁]的年龄明显小于HHS([78±5)岁(]P=0.008)。DKA、DKA-HHS和HHS的病死率分别是5.4%、20.0%和25.0%。不论高渗程度如何,所有DKA的病死率为9.6%;而不论酸中毒程度如何,所有HHS的病死率为22.2%。Logistics回归分析表明,年龄、血渗透压和糖尿病病程与死亡均有明显的关系,但血渗透压为HEs死亡的独立预测因子。结论虽然年龄和高渗程度均影响HEs的死亡,但发现只有血渗透压是死亡风险的独立预测因子。【Objective】 To examine the presentation profiles and prognostic factors for hyperglycaemic emergencies patients admitted with diabetic ketoacidosis and/or hyperosmolarity.【Methods】 A retrospective analysis of 64 admissions to kailuan Hospital between 1999～2009 was carried out.【Result】 Of the patients surveyed,the constituent ratios of DKA,DKA-HHS and HHS were 57.8%,23.4% and 18.8%,respectively.Age at presentation for DKA patients [（58±12） years] and DKA-HHS patients [（64±16） years] were significantly less than HHS patients [（78±5） years]（P =0.008）.The fatality rates of DKA,DKA-HHS and HHS were 5.4%,20.0%,25.0%,respectively.For all presentations associated with DKA-regardless of the degree of hyperosmolarity-the fatality rates was 9.6%,however for all presentations associated with hyperosmolarity-regardless of the degree of acidosis-the fatality rates was 22.2%.Logistic regression analysis showed that age,diabetes duration and the degree of hyperosmolarity associated with death,but only osmolarity emerged as an independent predictor of death of HEs.【Conclusions】 Although both age and degree of hyperosmolarity influenced death,only serum osmolarity was an independent predictor of death.

关 键 词：高血糖急症 糖尿病性酮症酸中毒 高渗状态 血渗透压 病死率 

分 类 号：R587.2[医药卫生—内分泌]