脓毒症患者不同血糖水平对肝脏功能影响的分析

Effects of Blood Glucose Levels on Liver Functions in Sepsis Patients

目的探讨脓毒症患者不同血糖水平对肝脏功能的影响。方法采用回顾性队列研究的方法纳入2014年3月至2015年1月间的93例脓毒症患者,根据入重症医学科(ICU)当天最大血糖值是否超过10mmol/L进行分组,进一步评估两组患者入ICU后的血常规、肝肾功能和凝血功能。结果正常糖组(血糖≤10mmol/L)的患者相较于高糖状态组(血糖>10mmol/L)的患者而言,入ICU后第1天的血小板计数更低,总胆红素水平和直接胆红素水平更高,高密度脂蛋白胆固醇和低密度脂蛋白胆固醇较低,且凝血酶原时间、国际标准化比值和活化部分凝血活酶时间延长,抗凝血酶Ⅲ更少(P均<0.05)。所有检查指标在入ICU后的第7天两组差异无统计学意义(P>0.05)。结论在脓毒症患者中,血糖正常的患者可能存在程度更重的肝脏功能损伤。

Objective To explore the effects of blood glucose levels on liver functions in patients with sepsis treated in intensive care unit（ICU）.Methods We performed a retrospective study on 93 patients with sepsis between March 2014 to January 2015.Patients were divided into two groups according to the initial blood glucose levels when admitted to ICU：high glucose group（blood glucose10 mmol/L）and normal glucose group（blood glucose≤10mmol/L）.Routine blood test results,liver functions and coagulations function were compared between the two groups.Results On the first day of ICU admission,patients in normal glucose group had lower blood platelet count,higher total bilirubin（TB）and direct bilirubin（DB）levels,lower high density lipoprotein cholesterol（HDL-C）level,lower low density lipoprotein cholesterol（LDL-C）level,longer prothrombin time（PT）,longer international normalized ratio（INR）,longer activated partial thromboplastin time（APTT）and lower antithrombinⅢ（AT Ⅲ）level（P〈0.05）.However,seven days after ICU admission,there were no significant differences between the two groups（P〉0.05）.Conclusion In patients with sepsis,normal blood glucose level might represent severe liver damage.