不同剂量全身糖皮质激素对重度慢阻肺合并肺部感染患者血糖的影响

Effect of different glucocorticoid dose on blood glucose in severe COPD patients complicated with pneumonia

目的探讨不同剂量的全身糖皮质激素对慢阻肺患者血糖的影响。方法入选慢阻肺者按平均每天糖皮质激素总量分为低剂量组(A组)87例、中剂量组(B组)81例、高剂量组(C组)80例,检测其血糖水平,比较各组之间高血糖事件的发生率及出现高血糖时间的差异,并将中、高剂量组高血糖事件患者中血糖值与CPIS评分、APACHE II评分进行相关性分析。结果不同剂量组之间高血糖事件的发生率有差异,低、中剂量组较高剂量组出现高血糖时间长;中、高剂量组高血糖事件患者中血糖值与CPIS评分、APACHE Ⅱ评分值存在正相关。结论不同剂量的糖皮质激素的慢阻肺患者的高血糖事件发生率及出现高血糖的时间会有所不同,激素诱导高血糖的慢阻肺患者的高血糖与其生理健康状况及感染有一定的关系。

Objective To study the effect of different glucocorticoid dose on blood glucose in severe COPD patients complicated with pneumonia. Methods COPD patients were divided into three groups based upon the average glucocorticoid dose per-day,the low-dose group( n = 87),the middle dose group( n = 81) and the high dose group( n = 80). The difference of hyperglycemia events and time points were compared among the three groups,and the middle and high dose relative hyperglycemia events with CPIS score and APACHE II score were analyzed. Results There was a statistical difference in the incidence of hyperglycemia events among the three groups. The lowdose and middle dose groups had longer high blood glucose than the high dose group did. In the middle and high dose group,CPIS score and APACHE Ⅱ score were positively blood glucose. Conclusion Hyperglycemia events and time points are distinct in different dosage glucocorticoid in chronic obstructive pulmonary diseases,and glucocorticoid-relative glucose might be affected by physiologic condition and infection.