血糖变异度与呼吸危重症患者预后关系研究  

Relationship Between Glucose Variability and Prognosis of Patients with Critical Respiratory Disease

作　　者：王婴云[1] 周承惇[1] 陶珍[1] 李浩[1] 李杰[1] 王凌莉[1] 

机构地区：[1]深圳市福田区人民医院ICU,广东深圳518033

出　　处：《临床医学工程》2014年第11期1424-1426,共3页Clinical Medicine & Engineering

摘　　要：目的研究血糖变异度与呼吸危重症患者预后的关系。方法收集我院综合ICU呼吸危重患者90例,统计每例入院72 h血糖,据预后分为死亡组及存活组,各组内按时间分为24 h、48 h、72 h亚组,计算各组及亚组平均血糖(GLUave)、标准差(GLUsd)及变异系数(GLUcv),分析各亚组的GLUave、GLUsd及GLUcv变化趋势,比较两组急性生理和慢性健康状况(APACHEⅡ)评分、GLUave、GLUsd及GLUcv,运用受试者工作特征曲线对APACHEⅡ、GLUave、GLUsd及GLUcv预测死亡率的应用价值进行评价。结果亚组GLUave、GLUsd及GLUcv无显著变化趋势;死亡组APACHEⅡ、GLUave、GLUsd及GLUcv均高于存活组并有统计学意义(P<0.05);APACHEⅡROC曲线下面积(AUC)最大0.946,标准差AUC 0.762,变异系数AUC 0.689,平均血糖AUC 0.673。结论血糖变异度与呼吸危重症患者的预后密切相关,高血糖、高变异度增加患者的死亡风险。Objective To explore the relationship between glucose variability and prognosis of patients with critical respiratory disease. Methods 90 ICU patients with critical respiratory disease were collected, and the blood glucose at 72 h after admission was recorded. All cases were divided into survival group and death group according to prognosis. Within each group, three time points were set including 24 h subgroup, 48 h subgroup, and 72 h subgroup. The averages glucose （GLUave）, standard deviation （GLUsd） and coefficient of variation （GLUcv） of each groups at each time points were calculated and analyzed. The acute physiology and chronic health evalution （APACHE） Ⅱ score, GLUave, GLUsd and GLUcv were compared between survival group and death group. The values of APACHE Ⅱ, GLUave, GLUsd and GLUcv in predicting mortality were evaluated by ROC curve. Results GLUave, GLUsd and GLUcv had no significant changes in subgroups. The APACHE Ⅱ, GLUave, GLUsd and GLUcv of death group were significantly higher than those of survival group （P 〈0.05）. The area under curve （AUC） was 0.946 of APACHE Ⅱ,0.762 of standard deviations, 0.689 of coefficient of variation and 0.673 of average glucose. Conclusions Glucose variability is closely related to the prognosis of patients with critical respiratory disease. High average glucose and high glucose variability can increase the risk of death.

关 键 词：血糖变异度 呼吸危重症 预后 

分 类 号：R563[医药卫生—呼吸系统]