入院血糖水平对脓毒症患者脏器损伤严重程度及预后的影响

Effect of admission blood glucose levels on multiple organ injuries degrees and prognosis in the patients with sepsis

目的探讨入院血糖水平与脓毒症患者脏器损伤严重程度及预后的相关性。方法 316例首次发生脓毒症患者,根据患者入院时血糖的四分位数6.9、8.5、10.2 mmol/L分为Ⅰ组(n=61)、Ⅱ组(n=82)、Ⅲ组(n=93)及Ⅳ组(n=80)4组,分析各组血糖水平与脏器损伤严重程度及预后的相关性。结果 316例患者中134例出现多脏器损伤,发生率为42.4%,其中99例住院期间30 d内死亡,病死率为31.3%。入院血糖水平、糖尿病史、肌酸激酶同工酶(CK-MB)峰值、APACHEⅡ评分是脓毒症患者脏器损伤严重程度发生的预测因素。随着血糖的增高,30 d内死亡的危险性增大。结论入院血糖水平对脓毒症患者脏器损伤严重程度及预后有一定的预测价值。

Objective To evaluate the relationship between adimission blood glucose levels and multiple organ injuries degrees and prognosis in the patients with sepsis. Methods 316 patients with sepsis occurred for the first time,accord- ing to the admission blood sugar quartile 6.9, 8.5, 10.2 mmol/L of the patients were divided into I group （n=61）, the I1 group （n=82）, the 11 group （n=93） and 1V group （n=80） 4 groups,the blood glucose levels and visceral injury severity and prognosis of correlation of each group was analyzed. Results 134 cases with multiple organ damage of 316 patients,the incidence rate was 42.4%,among them,99 cases hospitalized during death within 30 d,the fatality rate of 31.3%.Hospital blood sugar level,diabetes history,CK-MB peak,APACHE II score was sepsis patients with visceral in- jury severity of predictors.With the increasing of blood sugar,increase the risk of dying within 30 d. Conclusion Hos- pital blood glucose level is an prognostic faetor for multiple organ injuries degrees and prognosis in the patients with sepsis.