危重病儿应激性高血糖临床分析(附35例报告)

Irritable hyperglycemia in critical diseased children

目的 探讨危重病儿血糖和胰岛素水平与病情和预后的关系。方法 分别用葡萄糖氧化酶法和放射免疫法对 3 5例危重病儿和 17例轻症病儿血糖和胰岛素进行测定。结果 单器官和多器官功能衰竭组血糖浓度分别为 8.97± 3 .2 2mmol/L ,13 .76± 7.89mmol/L(P <0 .0 1) ;两组胰岛素值分别为 45 .64± 18.73mU/L和 87.3 1± 41.78mU/L(P <0 .0 1)。血糖 <10mmol/L组 ,死亡率 13 .0 4% ;血糖 10 -15mmol/L组 ,死亡率 2 2 .2 2 % ;血糖 >15mmol/L组 ,死亡率 66.67%。死亡组血糖值 16.43± 8.3 1mmol/L。结论 危重病儿血糖浓度和胰岛素值与病情危重程度呈正相关。血糖值可作为判断病情和预后的参考指标。

Objective:To investigate the relationship between levels of blood glucose,insuline and organ failure,prognosis in children with critical disease.Methods:The levels of blood glucose,insuline were observed in 35 children with critical disease and 17 children with upper respitratory infection or bronchits.Results:The corresponding levels of blood glucose were 8.97±3.22mmol/L and 13.76±7.89mmol/L in patient involving in one or mutiple organ failure(P<0.01) and the corresponding levels of blood insuline were 45.64±18.73mU/L and 87.31±41.78mU/L(P<0.01).The mortalities were 13.04%,22.22%,and 66.67% in corresponding blood glucose levels of less than 10mmol/L,equal to 10-15 mmol/L and more than 15 mmol/L,respectively.The level of blood glucose reached to 16.43±8.31 mmol/L in the 7 died patients.Conclusion:The irritable hyperglycemia is closely associated with organ failure and prognosis.