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目的探讨入院24 h平均血糖水平对判断重症脓毒血症患者病情及预后的指导意义。方法选取2014年6月至2015年6月河南省濮阳市人民医院收治的167例重症脓毒血症患者作为研究对象,在入院即刻开始测量患者血糖水平。根据患者入院24 h血糖值将其分为5组:血糖偏低组(<4.5 mmol/L)(33例)、血糖正常组(4.5~7.0 mmol/L)(34例)、血糖轻度升高组(7.1~10.0 mmol/L)(33例)、血糖中度升高组(10.1~12.0 mmol/L)(33例)、血糖显著升高组(>12.0 mmol/L)(34例)。统计各组患者性别、年龄、入院后7 d内病死情况,并计算生存患者急性生理与慢性健康评分表(APACHEⅡ)评分。结果血糖中度升高组、血糖显著升高组患者入院后7 d内病死率均明显高于血糖正常组,差异均有统计学意义(均P<0.05);血糖轻度升高组、中度升高组及显著升高组患者的APACHEⅡ评分明显升高,且APACHEⅡ评分随血糖水平升高而升高,差异均有统计学意义(均P<0.05)。结论对于脓毒血症患者检测血糖水平可用于预测病情严重程度,病情程度与血糖升高水平呈正相关。
Objective To investigate the significance of 24 h average blood glucose level in admission to determine the severity and prognosis of patients with severe sepsis. Methods A total of 167 patients with severe sepsis admitted to Puyang People’s Hospital of Henan Province from June 2014 to June 2015 were selected as subjects and their blood glucose levels were measured immediately after admission. Patients were divided into 5 groups according to their blood glucose levels at 24 h admission: low blood glucose (<4.5 mmol / L) (33 patients), normal glucose (4.5-7.0 mmol / L) (34 patients) (7.1 to 10.0 mmol / L) (33 cases), moderate blood glucose (10.1-12.0 mmol / L) (33 cases) and hyperglycemia (> 12.0 mmol / L) . Statistics were made on the gender, age, and death within 7 days after admission, and APACHE II scores of surviving patients were calculated. Results The mortality of patients with moderate hyperglycemia and hyperglycemia was significantly higher than that of normal blood glucose within 7 days after admission (all P <0.05), and mild hyperglycemia The APACHEⅡscores of patients with degrees of hyperemia and those of patients with hyperextension increased significantly, and APACHEⅡscore increased with the increase of blood glucose, the difference was statistically significant (all P <0.05). Conclusion The detection of blood glucose levels in patients with sepsis can be used to predict the severity of the disease, the severity of the disease and the level of elevated blood glucose was positively correlated.