糖尿病患者不自觉低血糖发作的相关因素分析

An analysis of the factors related to development of hypoglycemia unawareness in patients with diabetes mellitus.

目的 探讨糖尿病患者不自觉低血糖（ＵＨ）发作的相关因素。方法 对３６ 例ＵＨ 和３０ 例自觉低血糖（ＡＨ）的有关资料进行统计学分析。结果 ＵＨ 组低血糖发作次数、既往低血糖发作史、肾脏病变和自主神经病变发生率明显高于ＡＨ 组。ＵＨ 发作与上述指标呈正相关。ＵＨ组糖化血红蛋白的水平低于ＡＨ 组，ＵＨ 发作与糖化血红蛋白呈负性相关。Ｌｏｇｉｓｔｉｃ 多因素回归分析，在调整既往低血糖史等诸影响因素后，低血糖发作次数与ＵＨ 发生呈显著正相关（ＯＲ＝３－９７ ，９５ ％ ＣＩ为１－７２ ～９－１６ ，Ｐ＝ ０－００２）。结论 低血糖反复发作是ＵＨ

Objective To investigate the factors related to hypoglycemia unawareness in patients with diabetes mellitus.Methods The thirteen items of clinical data were statistically studied in 36 patients with unawareness of hypoglycemia(UH)and 30 patients with awareness of hypoglycemia(AH).Results ①As campare with AH group,UH group had more episodes of hypoglycemia,the accidence of previous hypoglycemia and the prevalence of autonomic neuropathy and diabetic nephropathy(P<0\^05～<0\^001),but it had lower the level of glycosylated hemoglobin(P<0\^01).②According to the analysis of simple linear regression,the development of UH was significantly positively correlated with the number of hypoglycemia(r=0\^51,P<0\^01),the accidence of previous hypoglycemia(r=0\^36,P<0\^01),the prevalence of autonomic neuropathy(r=0\^29,P<0\^05)and diabetic nephropathy(r=0\^26,P<0\^05),whereas it was negatively correlated with the level of glycosylated hemoglobin(r=-0\^35,P<0\^01);Accoding to the Logistic regression analysis,after adjusting for some confounding factors,such as the accidence of previous hypoglycemia,ect,the number of episode of hypoglycemia were a significantly positively associated with the development of UH(OR=3\^97,95% confidence interval was 1\^72～9\^16,P=0\^002).Conclusion Recurrence of hypoglycemia was an independence risk factor for the development of hypoglycemia unawareness.