高血糖在危重症患儿病情发展及预后中的意义  

Significance of Hyperglycemia in Disease Development and Prognosis in Critically Ill Children

作　　者：谈小云[1] 

机构地区：[1]江西省儿童医院急诊科,南昌330006

出　　处：《实用临床医学（江西）》2013年第6期78-80,83,共4页Practical Clinical Medicine

摘　　要：目的研究高血糖在危重症患儿病情发展及预后中的意义。方法以145例危重症患儿为研究对象,以入院24 h内血糖监测的最高值为分组标准,Glu≤6.1 mmol.L-1为血糖正常组38例,6.1 mmol.L-1<Glu≤10.0 mmol.L-1为血糖轻度升高组67例,Glu>10.0 mmol.L-1为重度升高组40例,比较3组入院时的小儿危重病例评分(PCIS)和全身性感染相关性器官功能衰竭评分(SOFA)、实验室指标、ICU住院时间及死亡率。结果对比PCIS及SOFA评分,重度升高组(81.68±8.16)分、(7.14±2.84)分与轻度升高组(86.57±6.92)分、(5.95±2.68)分及正常组(86.24±6.57)分、(5.52±2.61)分比较差异均有统计学意义(均P<0.05),轻度升高组与正常组比较差异均无统计学意义(均P>0.05)。比较3组实验室指标(感染性指标、肝肾功能及心肌酶),重度升高组与轻度升高组及正常组各值比较差异均有统计学意义(均P<0.05),轻度升高组与正常组各值比较差异均无统计学意义(均P>0.05)。对比3组ICU住院时间,重度升高组(11.7±4.9)d与轻度升高组及正常组比较差异均有统计学意义(均P<0.05),轻度升高组与正常组比较差异无统计学意义(P>0.05)。对比3组死亡率,重度升高组(35%)与轻度升高组及正常组比较差异均有统计学意义(均P<0.05),轻度升高组与正常组比较差异无统计学意义(P>0.05)。结论危重患儿血糖升高与病情严重程度及预后密切相关,对其行血糖监测具有重要临床意义。Objective To investigate the prognosis in critically ill children. Methods significance of hyperglycemia According to the maximum in disease development and blood glucose values within 24 hours after admission, 145 critically ill children were divided into three groups： normal blood glucose group （blood glucose ≤ 6.1 mmol·L-1, n=38）, mild hyperglycemia group （6.1 mmol·L-1〈blood glucose ≤ 10.0 mmol· L-1, n=67）, and severe hyperglycemia group （blood glucose〉 10.0 retool· L-1, n= 40）. Pediatric critical illness score （PCIS） and systemic infection related organ failure assessment （SOFA） score, laboratory parameters, ICU stay and mortality were compared among the three groups on admission. Results Both PCIS and SOFA scores in severe hyperglycemia group （81.68±8.16 and 7.14±2.84, respectively） were significantly higher than those in mild hyperglycemia group（86.57±6.92 and 5.95±2.68, respectively） or normal blood glucose group （86.24±6.57 and 5.52±2.61, respectively） （P〈 0.05）. There were no significant differences in PCIS and SOFA scores between mild hyperglycemia group and normal blood glucose group （P〉0.05）. The differences in infection indicators, liver and kid- ney function and myocardial enzymes were significant between severe hyperglycemia group and mild hyperglycemia group, as well as between severe hyperglycemia group and normal blood glucose group （P〈0.05）, but not significant between mild hyperglycemia group and normal blood glucose group （P〉 0.05）. The length of ICU stay in severe hyperglycemia group [（11.7±4.9） days] was significantly longer than that in mild hyperglycemia group [（6.2±3.2） days] or normal blood glucose group [（6.7±3.6） days]（P〈0.05）. There were no significant differences in the length of ICU stay between mild hyperglycemia group and normal blood glucose group （P〉0.05）. The mortality in severe hyperglycemia group（35%） was significantly higher than that in mild hyperglycemia group （13.

关 键 词：危重症 高血糖 儿童 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]