糖尿病合并新型冠状病毒肺炎患者死亡危险因素分析  

Risk factors analysis on the death of COVID-19 patients combined with diabetes mellitus

作　　者：刘海玲[1] 吴小军[1] 聂汉祥[1] 罗豫川 LIU Hailing;WU Xiaojun;NIE Hanxiang;LUO Yuchuan(Dept.of Respiratory and Critical Care Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院呼吸与危重症医学科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2022年第1期6-10,18,共6页Medical Journal of Wuhan University

摘　　要：目的:探讨糖尿病合并新型冠状病毒肺炎(COVID-19)患者死亡的危险因素。方法:回顾性分析武汉大学人民医院2020年2月至2020年4月收治的糖尿病合并COVID-19患者110例,详细记录患者性别、年龄、发病到入院时间、临床症状、是否合并高血压、是否使用激素、是否合并多脏器功能损伤等基本资料,同时记录入院时中性粒细胞、血小板、淋巴细胞、C反应蛋白(CRP)、血清降钙素原(PCT)、随机血糖、乳酸脱氢酶(LDH)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、超敏肌钙蛋白I、手指指脉氧饱和度(SPO2)、D-二聚体、氨基末端脑钠肽前体(NT-proBNP)等检验指标。根据临床结局分为存活组和死亡组,对比两组一般资料和检验结果,采用Logistic回归方法进行糖尿病合并COVID-19患者死亡危险多因素分析。结果:2例患者因24 h内死亡被排除,最终108例患者纳入研究,男65例,女43例,年龄31~98岁,中位年龄65岁,其中存活91例(存活组),死亡17例(死亡组),死亡率17.27%。影响糖尿病合并COVID-19死亡的单因素有:年龄、中性粒细胞、淋巴细胞、血小板、LDH、NT-proBNP、脏器损害、合并高血压、指脉氧饱和度<93%、PCT、超敏肌钙蛋白I、D-二聚体(P<0.05)。性别、发病到入院时间、CRP、ALB、ALT、AST、随机血糖及激素治疗在两组间无差别(P>0.05)。多因素Logistic回归分析显示年龄、淋巴细胞计数≤0.8×10^(9)/L及LDH≥550 U/L是糖尿病合并COVID-19患者死亡的危险因素(P<0.05)。结论:糖尿病合并COVID-19患者死亡率高,高龄、淋巴细胞计数≤0.8×10^(9)/L及LDH≥550 U/L可能是糖尿病合并COVID-19患者死亡的危险因素。Objective:To investigate the risk factors for death in COVID-19 patients combined with diabetes mellitus.Methods:A retrospective analysis on COVID-19 patients combined with diabetes mellitus admitted to Renmin Hospital of Wuhan University from February 2020 to April 2020 were performed,and the gender,age,time of onset to admission,clinical symptoms,whether combined with hypertension,whether to use hormones,multiple organ function damage and other basic informations were recorded.At the same time,we collected the on admission neutrophil count,platelet count,lymphocyte count,C-creactive protein(CRP),serum calcitonin(PCT),random blood glucose,lactate dehydrogenase(LDH),alanine aminotransferase(ALT),aspartate aminot-ransferase(AST),allergic troponin I,finger vein oxygen saturation,D-dimer,NT-proBNP,and other indicators.According to the clinical outcomes,the patients were divided into survival group and death group.The general data and test results between the two groups were compared,and the risk of death from diabetes and COVID-19 was analyzed by Logistic regression.Results:Two patients were excluded due to death within 24 hours.Finally,108 patients were included in the study,including 65 males and 43 females,aged from 31 to 98 years old,with a median age of 65 years,of which 91 survived(survival group)and 17 died(death group),with a mortality rate of 17.27%(19/110).The univariate analysis showed that age,levels of neutrophils,lymphocytes,platelets,LDH,and NT-proBNP,organ damage,hypertension,finger pulse oxygen saturation less than 93%,PCT,hypersensitive troponin I,D-dimer(P<0.05)were risk factors for death.There was no differrence in sex,time from onset to admission,CRP,ALB,ALT,AST,random blood glucose and hormone therapy between the two groups.Multivariate Logistic regression analysis showed that age,lymphocyte counts≤0.8×10^(9)/L and LDH≥550 U/L were risk factors for death in COVID-19 patients with diabetes mellitus.Con-clusion:The COVID-19 patients combined with diabetes mellitus have high mortality.The ris

关 键 词：新型冠状病毒肺炎 糖尿病 年龄 淋巴细胞 乳酸脱氢酶 

分 类 号：R563.1[医药卫生—呼吸系统]