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目的研究重症患者早期基础血糖浓度分布与病情程度间相关性,进行生存分析。方法根据2009年1—6月入科监测的基础血糖值,将207例重症患者分成3组:A组,血糖<4.5 mmol/L;B组,血糖4.5～8.3 mmol/L;C组,血糖>8.3 mmol/L。统计分析各组患者危重程度及预后指标。结果 (1)A组患者的APACHEⅡ评分(22.54±13.46)显著高于B组(10.30±6.23)和C组患者(14.74±8.49),差异有统计学意义(P<0.05);(2)A组患者MODS发生率、感染发生率、血管活性药物使用率分别为75.0%、62.5%、50.0%,与B、C组患者比较有明显差异(P<0.05);(3)A组患者基础血糖浓度与APACHEⅡ、MODS和SOFA评分均存在显著相关性,C组患者仅与APACHEⅡ评分存在相关(P<0.01);(4)生存分析显示A组患者较B、C组患者比较,28 d生存值明显降低,存活率仅54.2%(P<0.01)。结论早期基础血糖的监测与评估可以作为对重症患者病情和预后判断的一项重要指标。血糖浓度低于4.5 mmol/L时,应尽早进行干预治疗及器官功能保护。
Objective To study the correlation between the early basal blood glucose concentration distribution and the severity of illness in critically ill patients for survival analysis. Methods According to the basic blood glucose monitoring value from January to June 2009, 207 severe cases were divided into three groups: group A with blood glucose <4.5 mmol / L; group B with blood glucose 4.5 ~ 8.3 mmol / L; group C with blood glucose > 8.3 mmol / L. Statistical analysis of each group of patients with the severity and prognosis indicators. Results (1) APACHEⅡscore in group A (22.54 ± 13.46) was significantly higher than that in group B (10.30 ± 6.23) and group C (14.74 ± 8.49), the difference was statistically significant (P <0.05); (2) A The incidence of MODS, incidence of infection and vasoactive drug use were 75.0%, 62.5% and 50.0% in group B and C, respectively (P <0.05). (3) The basal blood glucose (P <0.01). (4) Survival analysis showed that the survival rate of group A was significantly higher than that of group B and C (P <0.01) Significantly reduced, the survival rate was only 54.2% (P <0.01). Conclusion The monitoring and assessment of early basal blood glucose can be used as an important index to judge the severity and prognosis of critically ill patients. Blood glucose concentrations below 4.5 mmol / L, should be as early intervention and organ function protection.