2型糖尿病合并慢性阻塞性肺疾病急性加重期血糖控制与预后的关系

The relationship of prognosis with the average blood glucose in acute exacerbations of chronic obstructive pulmonary diseases(AECOPD) during hospitalization

目的:分析2型糖尿病合并慢性阻塞性肺疾病急性加重期(AECOPD)患者住院期间的平均血糖水平与患者预后的相关性。方法:查阅2009年1月至2010年12月,在我院呼吸科及急诊重症监护室(EICU),以糖尿病合并慢性阻塞性肺疾病急性加重期入院的患者135例,且住院时间不少于5 d。住院期间每日监测血糖不少于4次的患者的病例资料,根据住院期间不同的平均血糖值(MBG)分组,观察MBG与不良事件发生数、病死率的相关性。结果:3组患者住院期间MBG为7.8～11.1 mmol/L的患者,主要不良事件发生率及病死率显著低于平均血糖<7.8 mmol/L和>1.1 mmol/L组,差异有统计学意义。结论:在2型糖尿病合并慢性阻塞性肺疾病急性加重期患者,平均血糖水平控制在(7.8～11.1mmol/L)范围内时安全性好,病死率低。

Objective：Analyze the relationship between the average blood glucose in acute exacerbations of chronic obstructive pulmonary diseases with type 2 diabetes mellitus patients during hospitalization and its prognosis.Methods：This retrospective study included 135 cases about the acute exacerbations of chronic obstructive pulmonary diseases patients with diabetes in our respiratory department and emergency intensive care unit during January 2009 to December 2010 who stayed in hospital no less than 5 days.These cases,which patients were monitored on blood glucose no less than 4 times a day during hospitalization,were divided into three groups according to differences of the average blood glucose（MBG）.The relationship between MBG and the incidence and fatality rate of adverse events were studied.Results：The incidence of major adverse events and fatality rate of patients whose MBG were 7.8-11.1 mmol/L during hospitalization were significantly lower than the results of the 7.8 mmol/L and the 11.1 mmol/L.Conclusion：It indicates that the security and low fatality rate of the average blood glucose level of the diabetic patients with AECOPD should be controlled at the range between 7.8-11.1 mmol/L during hospitalization.