糖尿病患者发生低血糖症的危险因素分析

Analysis of Risk Factors for Hypoglycemia in Patients with Diabetes

目的探讨糖尿病患者发生低血糖症的相关危险因素。方法选择我院急诊科收治的糖尿病低血糖症82例(低血糖症组),另选取同期住院治疗未发生低血糖症的糖尿病98例(对照组)进行回顾性对比研究,分析糖尿病低血糖症的相关危险因素。结果纳入的危险因素包括性别、年龄、糖尿病病程、饮食不当、治疗方案改变、运动不当、感染史、肝肾功能异常、认知功能障碍、糖尿病健康教育经历、合用其他药物、独居。对比研究显示低血糖症组治疗方案改变、肝肾功能异常、认知功能障碍者比例明显高于对照组;而有糖尿病健康教育经历者比例明显低于对照组,两组比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示性别、年龄、糖尿病病程、饮食不当、运动不当、感染史、肝肾功能异常、合用其他药物、独居为混杂因素;与糖尿病低血糖症显著相关的因素为治疗方案改变(P=0.003,OR=2.833)、认知功能障碍(P=0.013,OR=2.668)、糖尿病健康教育经历(P=0.002,OR=0.349);结合OR值和95%可信区间发现治疗方案改变、认知功能障碍为独立危险因素,而糖尿病健康教育经历为保护因素。结论治疗方案改变、认知功能障碍为糖尿病患者发生低血糖症的独立危险因素,而糖尿病低血糖症的发病率随着糖尿病健康教育经历的丰富显著降低。

Objective To investigate the risk factors of hypoglycemia in patients with diabetes. Methods 82 patients of hypoglycemia with diabetes were selected as the hypoglycemia group and 98 diabetic patients without hypoglycemia were selected as the control group. The risk factors of hypoglycemia in patients with diabetes were analyzed. Results Risk factors included gender, age, course of diabetes, improper diet, change of treatment strategies, improper movement, infection history, liver and renal dysfunction, cognitive impairment, experience of diabetes heahh education, treatment with other drugs and living alone. Comparative analysis of the above risk factors showed that the rates of change of treatment strategies, liver dysfunction, renal dysfunction and eognitive impairment were significantly higher than that in control group, and the rates of the experience of diabetes health education was signifieantly lower than that in control group with statistical significance （P 〈 0.05 ）. However, multivariate logistic regression analysis revealed that gentler, age, course of diabetes, improper diet, improper movement, infection history, liver and renal dysfunction, treatment with other drugs and living alone were confounding factors. Change of treatment strategy （ P = 0. 003, OR = 2. 833 ）, cognitive impairment （ P = 0. 013, OR = 2. 668 ） and experience of diabetes health education （ P = 0. 002, OR = 0. 349） were significantly related to hypoglycemia in patients with diabetes. Based on an overall consideration of odds ratio （OR） with 95% of confidence interval （ CI）, we found that change of treatment strategies and cognitive impairment were the independent risk factors for hypoglycemia in patients with diabetes, and experience of diabetes health educa- tion was independent protective factors. Conclusion Change of treatment strategies and cognitive impairment are the independ- ent risk factors for hypoglycemia in patients with diabetes, and strengthened health education about the disease will result in a significant decrease in the incidence rate of hypoglycemia diabetes.