糖尿病患者酮症酸中毒危险因素的巢式病例对照研究  

A nested case-control study of risk factors for ketoacidosis in patients with diabetes mellitus

作　　者：刘晨红 赵英娜 刘艳存[1] 么颖 LIU Chenhong;ZHAO Yingna;LIU Yancun;YAO Ying

机构地区：[1]天津医科大学总医院急诊医学科,天津市300041

出　　处：《中华急危重症护理杂志》2024年第9期773-778,共6页Chinese Journal of Emergency and Critical Care Nursing

基　　金：国家自然基金面上项目(82172120);天津医科大学护理学科专项发展基金项目(2022XKZX-01)。

摘　　要：目的探讨糖尿病患者酮症酸中毒(diabetic ketoacidosis,DKA)的危险因素。方法选取自2022年起在天津市某三级甲等医院自愿参与糖尿病高血糖危象风险等级评估相关项目的糖尿病患者为研究对象,截至2023年7月发生DKA的患者200例为病例组,按照性别、年龄进行1:1匹配,选择200例随访期间未发生DKA的患者为对照组。采用单因素和多因素Logistic回归模型对糖尿病患者DKA的危险因素进行统计分析。结果病例组中男106例,年龄为(52.14±19.38)岁,对照组中男108例,年龄为(52.17±19.39)岁。多因素Logistic回归显示,住院时间长、有急性感染史、随机血糖高、糖化血红蛋白异常、肝功能异常、肾功能异常的糖尿病患者更易发生DKA;有家族史、饮食规律的糖尿病患者更不易发生DKA。结论家族史、饮食规律性、住院时间、急性感染史、随机血糖、糖化血红蛋白、肝功能、肾功能是发生DKA的影响因素,可为临床工作者早期识别DKA提供参考依据。Objective To investigate the risk factors for ketoacidosis in patients with diabetes.Methods The subjects of this study were diabetic patients who voluntarily participated in the risk assessment of diabetic hyperglycemic crisis in the General Hospital of Tianjin Medical University since 2022.200 patients who developed ketoacidosis as of July 2023 were recruited as case group.200 patients who did not develop ketoacidosis during the follow-up period were matched 1:1 according to sex and age,and selected as the control.Univariate and multivariate logistic regression model were used to statistically analyze the risk factors of ketoacidosis in diabetic patients Results There were 106 males in the case group with an average age of(52.14±19.38)years,and 108 males in the control group with an average age of(52.17±19.39)years.Multivariate logistic regression showed that long hospital stay,history of acute infection,high random blood glucose,abnormal glycated hemoglobin,abnormal liver function,and abnormal renal function were risk factors for the development of DKA.Family history and dietary regularity were protective factors for DKA.Conclusion Family history,diet regularity,length of hospital stay,history of acute infection,random blood glucose,glycated hemoglobin,liver function and renal function are the influencing factors of ketoacidosis,which provides a reference for clinicians to identify ketoacidosis early.

关 键 词：糖尿病 酮症酸中毒 危险因素 巢式病例对照研究 护理 

分 类 号：R473.5[医药卫生—护理学]