影响糖尿病酮症酸中毒患者预后相关因素研究

Effects of Factors Associated with Prognosis in Patients with Diabetic Ketoacidosis

目的:探讨影响糖尿病酮症酸中毒(DKA)患者预后的相关因素。方法:选择我院2011年6月至2014年5月入院的糖尿病酮症酸中毒患者共122例,依预后情况分为生产组及死亡组,通过观察对比各组患者预后相关因素。结果:本组122例患者均给予糖尿病酮症酸中毒对症治疗,其中患者死亡共17例,病死率13.9%,存活105例。对比影响糖尿病酮症酸中毒的一般预后因素方面显示,各项资料均无统计学意义,P>0.05,12h后预后相关因素显示,患者血糖及胰岛素用量为影响糖尿病酮症酸中毒预后的因素,P<0.05,24h后预后相关因素显示,患者意识障碍及发热为影响糖尿病酮症酸中毒预后的因素,P<0.05,多因素Logistic回归分析中显示,12h血糖、胰岛素用量,24h意识障碍、发热为影响糖尿病酮症酸中毒预后的独立危险因素。结论:12h血糖、胰岛素用量,24h意识障碍、发热对糖尿病酮症酸中毒患者预后具有影响,统计分析DKA患者入院24h内临床及实验室指标,可以分层分析DKA患者的危险程度,并给予针对性处理。

Objective： To study the effect of diabetic ketoacidosis （DKA） related prognostic factors.Methods：In our hospital from 2011 June to 2014 May revenues of diabetic ketoacidosis patients with a total of 122 cases,according to the prognosis of patients divided into group and death group,the prognosis of the patients were compared by observing the relevant factors.Results：In this group,122 patients were given symptomatic treatment of patients with diabetic ketoacidosis,of which there were 17 death cases,the mortality rate was 13.9%,105 cases of survival.Comparison of effects of general prognostic factors of diabetic ketoacidosis,the data had no statistical significance,P 〉0.05,show the prognostic factors of 12h,blood glucose and insulin in patients with diabetic ketoacidosis were factors influencing the prognosis,P 〈 0.05,24h prognosis related factors,patients with disturbance of consciousness and fever as the influencing factors of diabetic ketoacidosis the prognosis,P 〈 0.05,the multi factor Logistic regression analysis showed that,12h blood glucose,insulin dosage,heating 24 h disturbance of consciousness,affect the prognosis of diabetic ketoacidosis independent risk factor.Conclusion：12h blood glucose,insulin dosage,heating 24 h disturbance of consciousness,has the influence on the prognosis of patients with diabetic ketoacidosis,statistical analysis of clinical and laboratory parameters in patients with DKA within 24h after admission,the degree of risk in DKA patients can be stratified analysis,and gives the targeted treatment.