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目的:研究老年2型糖尿病患者发生严重低血糖的相关危险因素。方法:选取2013年7月到2014年7月我院收治的老年2型糖尿病患者200例,根据是否发生严重低血糖将患者分为非低血糖组(138例)和低血糖组(62例),比较两组临床资料。结果:低血糖组和非低血糖组体重指数、住院时间以及糖尿病病程比较差异具有统计学意义(P<0.05);低血糖组心脑血管疾病药物联用率显著高于非低血糖组,二甲双胍应用率显著低于非低血糖组,胰岛素应用率以及口服降糖药(OAD)和胰岛素的联合应用率显著高于非低血糖组,两组比较差异具有统计学意义(P<0.05);低血糖组低钾血症发生率显著高于非低血糖组,肾功能有关的指标显著高于非低血糖组,低血糖组白细胞和中性粒细胞显著高于非低血糖组,两组比较差异具有统计学意义(P<0.05);Logistic多因素回归分析可知,病程超过10年、胰岛素应用以及和OAD联用、果糖胺低于2.5 mmol/L、白细胞升高、肾功能受损均和严重低血糖发生具有相关关系。结论:病程超过10年、胰岛素应用以及和OAD联用、白细胞升高、果糖胺低于2.5 mmol/L、肾功能受损均和严重低血糖发生有关,在行降糖治疗时应该谨慎评估上述危险因素。
Objective: To study the risk factors associated with severe hypoglycemia in elderly type 2 diabetic patients. Methods: A total of 200 elderly type 2 diabetic patients admitted from July 2013 to July 2014 in our hospital were divided into non-hypoglycemia group (n = 138) and hypoglycemia group (n = 62) according to whether there was any serious hypoglycemia. , Comparing two groups of clinical data. Results: There was significant difference in body mass index, length of hospital stay and duration of diabetes among hypoglycemic group and non-hypoglycemic group (P <0.05). The combination rate of cardio-cerebrovascular disease in hypoglycemia group was significantly higher than that in non-hypoglycemia group, metformin The application rates of insulin and oral hypoglycemic agents (OAD) and insulin were significantly higher than those of non-hypoglycemia group (P <0.05), and the rates of insulin utilization and insulin lowering were significantly lower than those of non-hypoglycemia group The incidence of hypokalemia in the blood glucose group was significantly higher than that in the non-hypoglycemia group, the indexes related to renal function were significantly higher than those in the non-hypoglycemia group, and the levels of leukocytes and neutrophils in the hypoglycemia group were significantly higher than those in the non-hypoglycemia group (P <0.05). Logistic multivariate regression analysis showed that over 10 years of course of the disease, the combination of insulin and OAD, fructosamine less than 2.5 mmol / L, leukocytosis and impaired renal function were all significant Hypoglycemia is related. CONCLUSIONS: Over 10 years of insulin resistance, combined with OAD, leukocytosis, hypoglycemia below 2.5 mmol / L, and impaired renal function are associated with severe hypoglycemia. These hypoglycemic agents should be evaluated carefully Risk factors.