慢性肺源性心脏病急性加重期糖代谢异常及干预对预后的影响

Glucose metabolism abnormality and prognostic effect in patients with acute episode of pulmonary heart disease.

目的探讨慢性肺源性心脏病患者急性加重期糖代谢异常及干预对预后的影响。方法将2004年1月-2007年6月呼吸内科住院治疗的无糖尿病病史的肺心病急性加重期患者216例进行空腹血糖检测,发现非糖尿病性高血糖患者144例,一过性高血糖79例和持续性高血糖65例,正常血糖组72例。持续性高血糖组再随机分为口服降糖药或胰岛素干预组33例及对照组32例,对血糖结果、平均住院日、住院病死率及相关临床情况进行收集分析。结果平均住院日持续性高血糖干预组为（17.42±10.91）d,对照组（24.32±12.62）d,差异具有统计学意义（P〈0.05）。一过性高血糖组平均住院日数为（15.62±6.71）d,正常血糖组为（16.34±6.32）d,差异无统计学意义（P〉0.05）。住院期间病死率正常血糖组为11.4%,一过性血糖升高组12.6%,持续性高血糖干预组13.7%,持续性高血糖对照组为34.1%。持续性高血糖干预组与对照组比较住院期间病死率差异具有统计学意义（P〈0.05）。结论肺源性心脏病患者糖代谢异常发生率高,控制患者血糖能缩短住院日期及降低病死率。

Objective To study glucose metabolism abnormality in patients with acute episode of pulmonary heart diesease and prognostic effect.Methods 216 patients were admitted to respiratory department from 2004.1 to 2004.7, These patients were divided into non-diabetic hyperglycemia group（ n = 144） ,which was divided into two subgroups： transient hyperglycemia group（ n = 79）and persistent hyperglycemia group（ n = 65） and normoglycemic group（ n = 72）. Persistent hyperglycemia group were randomly divided into treatment group（ n = 33）and control group（ n = 32） .The average of length stay,mortality in hospital and other relative factors were compared beteen these groups. Results The average length of hospital stay was longer in persistent hyerglycemia control group than the normoglycemic group and transient hyperglycemia group and persistent hyperglycemia treatment group （ P 〈 0.05 ）. Mortality of control group were higher than other three group（ P 〈 0.05 ）. Conclusion Glucose metabolism abnormality in patients with acute episode of pulmonary heart disease is higher,effective control blood glucose can shorten the hospital stay and reduce the mortality.