老年2型糖尿病患者发生严重低血糖的危险因素分析

Research on the Risk Factors of Severe Hypoglycemia for Elderly Patients with Type 2 Diabetes Mellitus

目的研究2型糖尿病老年患者发生严重低血糖的危险因素。方法我院2014年1月—2016年12月期间收治的2型糖尿病老年患者120例(年龄≥60岁)作为研究对象,收集患者一般资料,根据患者住院期间是否发生严重低血糖分为两组。观察组为住院期间发生严重低血糖的患者共40例,对照组为住院期间未发生严重低血糖的患者共80例。观察两组患者资料差异情况,采用Logistic回归方程进行计算,分析导致2型糖尿病老年患者严重低血糖的危险因素。结果两组患者在体质指数(Body Mass Index,BMI)、病程、心血管药物以及降糖药物上有明显差异,P<0.05。两组患者在果糖胺、白细胞计数(white blood cell,WBC)、尿素氮(blood urea nitrogen,BUN)、肌酐(creatinine,Cr)以及糖化血红蛋白(Hemoglobin A1c,HbA1c)水平上均有差异,P<0.05。将上述有差异项目带入Logistic回归方程,计算发现BMI、病程、心血管药物、降糖药物、果糖胺以及WBC是2型糖尿病老年患者严重低血糖的危险因素。结论老年2型糖尿病患者发生严重低血糖的因素较多,包括BMI较低、病程较长、心血管药物联用、OAD与胰岛素联用降糖、果糖胺降低以及WBC水平升高。临床上应根据患者自身情况针对性实施干预,以降低2型糖尿病老年患者严重低血糖的发生率。

Objective To study the risk factors of severe hypoglycemia for elderly patients with type 2 diabetes mel- litus （T2DM）. Methods 40 elderly T2DM patients （ I〉60 years old） treated from January 2014 to December 2016 in our hospital were selected. The clinical data was collected. The subjects were divided into observation group （20 cases） and con- trol group （20 cases） according to the incidence of severe hypoglycemia. The observation group had the severe hypoglycemia, and the control group had not the severe hypoglycemia. Through the Logistic regression analysis, the risk factors of severe hy- poglycemia were analyzed. Results The index of BMI, disease course, cardiovascular drug and hypoglycemia agent for two groups was significantly different（ P 〈 0.05 ） ; The index of fructosamine, WBC, BUN, Cr and HbAlc for two groups was sig- nificantly different （ P 〈 0. 05 ） ; Through the Logistic regression analysis, the risk factors of severe hypoglycemia included BMI, disease course, cardiovascular drug, hypoglycemia agent, fructosamine and WBC. Conclusion For elderly patients with T2DM, the influence factors of severe hypoglycemia include the lower BMI, longer disease course, combination of cardiovascular drug and OAD, combined therapy of insulin and hypoglycemia agent, lower fructosamine and higher WBC. In clini- cal practice, the nursing intervention can reduce the incidence rate of severe hypoglycemia.