Ⅱ型糖尿病合并多脏器功能衰竭临床分析

CLINICAL STUDY ON NIDDM PATIENTS WITH MULTIPLE ORGAN FAILURE

目的：为初步探讨Ⅱ型糖尿病（ＮＩＤＤＭ）合并多脏器功能衰竭（ＭｕｌｔｉｐｌｅＯｒｇａｎＦａｉｌｕｒｅ，ＭＯＦ）的临床情况，提出ＮＩＤＤＭ合并ＭＯＦ的防治措施；方法：回顾性分析的方法探讨了３１例ＮＩＤＤＭ合并ＭＯＦ的临床特点；结果：表明：①ＮＩＤＤＭ发生ＭＯＦ最常见的诱因为肺部感染（７０．９％），其次为心梗（１６．１％）。②ＮＩＤＤＭ发生ＭＯＦ的患者中衰竭脏器的发生率以肾衰最多（６４．５％），其次为心衰（２２．６％）。③ＮＩＤＤＭ发生ＭＯＦ患者中首发脏器中以肾脏最多（７４．２％），其次为心脏（１６．１２％）。④ＮＩＤ－ＤＭ合并ＭＯＦ患者的死亡率随脏器衰竭数目的增多而增高，两者之间呈正相关（ｒ＝０．７３２）；结论：ＮＩＤ－ＤＭ患者极易合并ＭＯＦ，其死亡率极高，这与ＮＩＤＤＭ基础条件差，体内存在发生ＭＯＦ的异常的免疫反应，抵抗力差。

Objective: In the paper, 31 NIDDM patients with multiple organ failure(MOF) were discussed and some measures were suggested to be taken to prevention and treatment for NIDDM patients with MOF.Method:the reviewing analysis.among the inducing factors of MOF Results:NIDDM patients,lung infection (70.9%)was the most common one and myocardial infarction (16.1%) was the second one.in failure organs,renal failure(64.5%)was the most common and heart failure was the next(22.6%).for the organ which failed firstly among the failure organs,renal(74.2%)was the most common and heart was the next(16.12%).The more the number of failure organ,the higher the mortality of NIDDM patients with MOF.Their related coefficient was 0.732(r=0.732).Conclusion:the mortality of NIDDM patients with MOF was very high because their immunologic function was low and immune clearance and defensive function against free radical was very weak in NIDDM patients,which might play an important role in diabetic microangiopathic.