新诊糖尿病合并肺部感染与血糖及糖化血红蛋白水平切点的探讨

Exploration of new diagnosis of diabetes complicated with pulmonary infection and level point of blood glucose and glycated hemoglobin

目的探讨新诊糖尿病合并肺部感染与血糖及糖化血红蛋白（Hb Alc）的相关性及切点。方法回顾性分析2012年至2015年入住我院内分泌科340例糖尿病合并肺部感染患者为的临床资料,所有研究对象均记录年龄、性别,测量身高、体质量,腰围（WC）、收缩压（SBP）和舒张压（DBP）,同时测定各项生化指标,采用SPSS17.0统计软件进行统计学分析,通过绘制受试者工作（ROC）曲线,确定空腹血糖（FBG）、Hb Alc的最佳切点。结果 1感染组的Hb Alc（8.1±0.7）、FBG（9.7±1.6）均明显高于非感染组的Hb Alc（6.7±0.4）、FBG（7.3±1.8）,P〈0.001,感染组的年龄（52.8±7.9）、BMI（28.2±3.6）均高于非感染组的年龄（46.9±7.2）、BMI（22.8±3.6）,P〈0.05;2以糖尿病对肺部感染患病影响明显的为Hb Alc（相关性数B=6.623,OR=9.230,95%CI 4.438-25.62,P〈0.0001）,其次为FBG（相关性数B=0.542,OR=1.15,95%CI 1.052-1.224,P=0.013）,再者为BMI（相关性数B=0.203,OR=1.850,95%CI 1.039-2.542,P=0.024）及年龄（相关性数B=0.042,OR=1.041,95%CI 1.020-1.072,P=0.028）;3受试者工作（ROC）曲线分析Hb Alc、FBG及BMI等指标的预测肺部感染增加的曲线下面积,分别为0.717、0.663及0.569,Hb Alc、FBG及BMI等指标的预测肺部感染增加的最佳切割点,分别为8.16%、9.82及27.8。结论新诊糖尿病患者的肺部感染与空腹血糖、糖化血红蛋白及年龄和体质量指数有关;新诊DM肺部感染的空腹血糖切点为9.82 mmol/L,糖化血红蛋白切点为8.16%。

Objective To explore a new diagnosis of diabetes mellitus complicated with pulmonary infection and the cutoff point of blood glucose and glycated hemoglobin（ Hb Alc）. Methods A total of 340 cases of diabetes complicated with pulmonary infection patients were enrolled for the study object by retrospective analysis from 2012 to 2015 in our hospital hospitalized in the Department of Endocrinology. It was recorded that age,sex,measurements of height,weight,waistline（ WC）,systolic blood pressure（ SBP）,diastolic blood pressure（ DBP） and simultaneous detected d various biochemical indexes,SPSS17.0 statistical software was used for statistical analysis,continuous variables express with mean ＋ standard deviation（ x ± s）,Two groups are compared by independent sample t test,and the optimal cut point of FBG,Hb Alc were detected by receiver operating curve（ ROC）,P〈0.05 for differences have statistical significance. Results 1Through independent samples t test showed that Hb Alc（ 8.1＋0.7）,FBG（ 9.7＋1.6） of infectd group were significantly higher than those in group on infected of Hb Alc（ 6.7＋0.4）,FBG（ 7.3＋1.8）,P〈0.001,the age（ 52.8＋7.9）and BMI（ 28.2＋3.6） of infectd group were higher than those in no infected group of the age（ 46.9＋ 7.2） and BMI（ 22.8＋ 3. 6）,P〈0. 05; 2 It was analyzed by Logistic with pulmonary infection and diabetes mellituspatients as the dependent variable,The pulmonary infection significantly affected the prevalence for HbA lc（ correlated with the number of B= 6.623,OR = 9.230,95%CI 4.438-25.62,P〈0.0001）,secondly for FBG（ correlated with the number of B = 0.542,OR = 1.15,95%CI 1.052-1.224,P = 0.013）. Furthermore（ BMI correlated with the number of B = 0. 203,OR = 1. 850,95% CI 1. 039-2. 542,P = 0. 024） and age（ correlated with the number of B = 0.042,OR = 1.041,95% CI 1.020-1.072,P = 0.028）;（3）The receiver operating curve（ ROC） analysis of HbA lc,fasting blood glucose and BMI index prediction of pulmonary infection area under the curve of increasing,were 0.717,0.663 and 0.569,HbA lc,fasting blood glucose and BMI index prediction of pulmonary infection increased the optimal cut-off point were 8. 16% and 9. 82 and 27. 8. Conclusions In newly diagnosed diabetic patients,pulmonary infection is related to fasting blood glucose, glycosylated hemoglobin and age and body mass index; For patients with new diagnosis of diabetes mellitus and pulmonary infection,fasting blood glucose cutoff is 9.82 mmol / L,glycosylated hemoglobin cutoff is 8.16%.