糖尿病患者治疗过程中发生低血糖的原因分析  

Study on the Causes of Hypoglycemia in Patients with Diabetes Mellitus during Therapy

作　　者：邹晓莹[1] 孙中华[1] 韩晶[2] 

机构地区：[1]吉林大学第一医院内分泌科,吉林省长春市130021 [2]武警吉林省总队医院

出　　处：《中国全科医学》2012年第6期690-693,共4页Chinese General Practice

摘　　要：目的探讨糖尿病患者治疗过程中发生低血糖反应的原因,为临床中糖尿病低血糖的预防提供一定的指导。方法选择2009年12月—2011年9月我院内分泌科收入院的糖尿病患者共200例。根据是否发生低血糖将其分为糖尿病未发生低血糖组(非低血糖组)及糖尿病发生低血糖组(低血糖组)。进行两组间患者临床和生化指标的比较,分析它们之间的相关性,并对低血糖组患者的治疗方案及发生低血糖时的各种诱发因素进行统计分析。结果(1)低血糖组患者体质指数(BMI)显著低于非低血糖组,而年龄、糖尿病病程、血肌酐水平、尿微量清蛋白定量显著高于非低血糖组,差异均有统计学意义(P<0.05)。(2)多因素Logistic回归分析表明,年龄、血肌酐、尿微量清蛋白是发生低血糖的独立危险因素;而BMI是糖尿病患者发生低血糖的保护因素(P<0.05)。(3)本组低血糖患者各种降糖治疗方案中,使用预混人胰岛素治疗导致低血糖所占比例最大,占32%。(4)在各种导致低血糖的诱发因素中,由于饮食不规律而致低血糖所占比例最大,占40.6%。结论糖尿病患者治疗中是否容易发生低血糖与患者的年龄、BMI、血肌酐水平、尿微量清蛋白有关,糖尿病患者低血糖的发生是多因素综合作用的结果。Objective To explore the causes for hypoglycemia during the therapy for patients with diabetes mellitus to provide guidance for the prevention of hypoglycemia in treating diabetes. Methods 200 patients with DM admitted into the De- partment of Endocrinology in the First Hospital of Jilin University From December 2009 to September 2011 were involved into the study. According to whether hypoglycemia occurs, the diabetic patients were divided into two groups （ non hypoglycemia group and hypoglycemia group） . Clinical and biochemical indicators were compared between the two groups, and then their correlations were analyzed. The treatment of the patients and the inducing factors of hypoglycemia were statistically analyzed in hypoglycemia group. Results （ 1 ） Body mass index was significantly lower but age, duration of diabetes, creatinine and urinary microalbu- min were significantly higher in hypoglycemia group than in non hypoglycemia group （P 〈 O. 05 ） . （2） The results of multivari- ate logistic regression analysis indicated that age, creatinine and urinary microalbumin were the independent risk factors for the occurrence of hypoglycemia, while BMI was a protective factor of hypoglycemia in patients with diabetes （ P 〈 0. 05 ） . （ 3 ） Premixed human insulin took the largest proportion in all kinds of treatments leading to hypoglycemia in this group of patients with hypoglycemia. （4） Irregular diet took the largest proportion in all kinds of inducing factors leading to hypoglycemia. Conclu- sion The occurrence of hypoglycemia during the treatment in diabetic patients is closely related to age, BMI, creatinine and u- rinary microalbumin. The occurrence of hypoglycemia in diabetic patients results from comprehensive effects of many factors.

关 键 词：糖尿病 低血糖 危险因素 临床方案 诱发因素 

分 类 号：R587.3[医药卫生—内分泌]