1726例住院患者糖代谢情况回顾性分析

Glucose metabolism in hospitalized patients:a retrospective analysis of 1726 cases

目的分析不同科室住院患者的血糖水平及相关资料,为院内血糖规范化管理提供依据。方法回顾性分析2014年11月我院9个科室1 726例出院患者资料,包括入院时血糖、各项代谢指标、住院天数及住院费用等,分析血糖异常情况及相关影响因素。结果有99.19%(1 712/1 726)的患者在住院期间至少检测过一次血糖。依据患者既往史、入院时或住院期间血糖检查结果,血糖异常者占42.76%(738/1 726);除内分泌科(73.79%,76/103)外,老年病科(54.17%,13/24)和胰腺外科(50.54%,93/184)血糖异常患者较多。新发血糖异常者393例,占分析患者的22.77%,其住院时间及住院费用等均高于既往确诊糖尿病及糖调节受损(IGR)与血糖正常患者(P<0.01)。既往确诊糖尿病及IGR患者血三酰甘油(TG)及血尿素(BUN)水平均高于血糖正常及新发血糖异常患者(P<0.05,P<0.01);既往确诊糖尿病及IGR与新发血糖异常患者血高密度脂蛋白胆固醇(HDL-C)水平均低于血糖正常患者(P<0.01),但既往确诊糖尿病及IGR与新发血糖异常患者间差异无统计学意义。结论住院期间新发高血糖不容忽视,应加强对高危人群入院及住院期间的血糖监测,并规范高血糖的院内管理。

Objective To analyze the blood glucose levels and related data of inpatients of different clinical departments, so as to provide a basis for normalized management of blood glucose in hospital. Methods Medical records of 1 726 discharged patients from 9 different clinical departments of Changhai Hospital in November 2014 were retrospectively analyzed using medical record inquiry system. The data included admission blood glucose, metabolic indexes, hospital stay and hospitalization expenses. The abnormal blood glucose and related factors were analyzed. Results We found that 99. 19% （1 712） of the 1 726 inpatlents had their blood glucose monitored once at least. According to their past medical history and blood glucose levels on admission or during hospitalization, 42. 76% （738） patients had pathoglycemia. Endocrinology department （73. 79% ,76/103）, geriatrics department （54. 17%, 13/24） and pancreatic surgical department （50.54%, 93/184） had more pathoglycemia patients than other departments. The patients with newly discovered pathoglycemia （393） accounted for 22. 77% of the inpatients, and the hospital stay and hospitalization expenses in these patients were significantly higher than patients with diabetes and impaired glucose regulation （IGR） and those with normal blood glucose （P〈0. 01）. The levels of serum triglyceride （TG） and blood urea （BUN） of diabetic and IGR mpatients were significantly higher than patients with newly discovered high glucose and normal glucose （P〈0.01）; the levels of high density lipoprotein cholesterol （HDL-C） in diabetic and IGR inpatients and those with newly discovered pathoglycemia were significantly lower than that in those with normal blood glucose （P〈0. 01）, but there was no significant difference between the former two groups. Collusion Newly discovered hyperglycemia during hospitalization Shoed not be overlooked. The blood glucose monitoring of high risk population should be reinforced on during hospitalization, and a standard management of hypergiycemia should be estabished.