重症肺结核患者血糖变异性相关指标表达水平及其对预后不良的预测效能分析  

Analysis of the expression level of blood glucose variability related indicators in patients with severe pulmonary tuberculosis and its predictive efficiency on poor prognosis

作　　者：吴国锋 陶晓东 张秀军 WU Guofeng;TAO Xiaodong;ZHANG Xiujun(Depart-ment of Pulmonology,Affiliated Hospital of Shaoxing University,Shaoxing 312000,China)

机构地区：[1]绍兴文理学院附属医院肺科,浙江绍兴312000

出　　处：《全科医学临床与教育》2024年第7期604-606,共3页Clinical Education of General Practice

摘　　要：目的探讨重症肺结核患者血糖变异性对预后不良的预测效能。方法根据预后情况将86例重症肺结核患者分为死亡组(n=23)与存活组(n=63),比较两组急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)及血糖变异性指标,分析患者预后不良(死亡)的危险因素及血清平均血糖值(GluAve)、血糖值标准差(GluSD)和血糖变异率(GluCV)对预后不良的预测效能。结果死亡组患者APACHEⅡ评分、血清GluSD、GluCV水平均高于存活组(t分别=4.66、3.10、3.19,P均<0.05)。进一步多因素logistic回归分析显示,血清GluSD、GluCV水平均为患者预后不良的影响因素(OR分别=3.13、17.70,P均<0.05),且二者联合预测重症肺结核患者预后不良的曲线下面积(AUC)为0.81,灵敏度为78.26%,特异度为77.78%。结论不同预后重症肺结核患者血糖变异性相关指标存在明显差异,GluSD、GluCV二者联合预测重症肺结核患者预后不良具有较高预测效能。Objective To investigate the predictive effect of blood glucose variability on poor prognosis in patients with severe pulmonary tuberculosis.Methods A total of 86 patients with severe pulmonary tuberculosis were divided in-to death group(n=23)and survival group(n=63)according to the prognosis.The APACHEⅡscores and blood glucose variability indexes of the two groups were compared,and the risk factors of patients with poor prognosis(death)and the predictive efficiency of serum GluAve,GluSD and GluCV on poor prognosis were analyzed.Results The APACHEⅡscore,serum GluSD and GluCV levels in death group were higher than those in the survival group(t=4.66,3.10,3.19,P<0.05).Further multivariate logistic regression analysis showed that serum GluSD and GluCV levels were both risk factors for poor prognosis in patients(OR=3.13,17.70,P<0.05),and the area under the curve(AUC)of their com-bined prediction of poor prognosis in severe pulmonary tuberculosis patients was 0.81,with a sensitivity of 78.26%and a specificity of 77.78%.Conclusion There are significant differences in the related indexes of blood glucose variability in patients with severe pulmonary tuberculosis with different prognosis.The combination of GluSD and GluCV has high effi-ciency in predicting poor prognosis in patients with severe pulmonary tuberculosis.

关 键 词：重症肺结核 血糖变异性 预后不良 预测效能 

分 类 号：R521[医药卫生—内科学]