静脉血糖和糖化血红蛋白在健康体检者和急诊室及ICU患者中的分布差异

Distribution of venous blood glucose and glycosylated hemoglobin in healthy persons,emergency room and ICU

目的研究健康体检者、急诊室患者、ICU患者中静脉血糖与糖化血红蛋白水平的分布差异。方法回顾性分析本院2019年7月至2020年7月收治的健康体检者100名(健康组)、急诊室患者100例(急诊室组)、ICU患者100例(ICU组)的临床资料,比较3组糖化血红蛋白、静脉血糖水平。结果 3组性别比较差异无统计学意义,健康组年龄小于急诊室组和ICU组(P<0.05),ICU组年龄小于急诊室组(P<0.05)。急诊室组糖尿病史占比(40.00%)高于ICU组(24.00%),ICU组死亡率(17.00%)高于急诊室组(5.00%),差异有统计学意义(P<0.05)。ICU组糖化血红蛋白≥6.5%与<6.5%的APACHEⅡ评分比较差异无统计学意义。急诊室组既往无糖尿病患者有24.00%入院静脉血糖≥7.8 mmol/L,糖化血红蛋白≥6.5%占比27.00%。ICU组既往无糖尿病患者有26.00%入院时随机静脉血糖≥7.8 mmol/L,糖化血红蛋白≥6.5%占比21.00%。结论静脉血糖水平在不同人群中的分布具有明显差异,急诊室与ICU患者具有较高的血糖异常率,因此,临床需完善个体化诊疗方案,健全血糖干预机制,以便于临床全面管理。

Objective To study the distribution differences of venous blood glucose and glycosylated hemoglobin levels among healthy people,emergency room patients and ICU patients.Methods The clinical data of 100 healthy people(healthy group),100 patients in emergency room(emergency room group)and 100 patients in ICU(ICU group)in our hospital from July 2019 to July 2020 were retrospectively analyzed,and the levels of glycosylated hemoglobin and venous blood glucose among the three groups were compared.Results There was no significant difference in gender among the three groups.The age of the healthy group was less than that of the emergency room group and ICU group(P<0.05),and the age of ICU group was less than that of the emergency room group(P<0.05).The proportion of diabetes history in the emergency room group(40.00%)was higher than that in the ICU group(24.00%),and the mortality rate in the ICU group(17.00%)was higher than that in the emergency room group(5.00%),the difference was statistically significant(P<0.05).In ICU group,there was no significant difference inAPACHEⅡscore between HbA1c≥6.5%and HbA1c<6.5%.In the emergency room group,24.00%of the patients without diabetes were admitted with venous blood glucose≥7.8 mmol/L,and 27.00%of the patients had glycosylated hemoglobin≥6.5%.In ICU group,26.00%of patients without diabetes had random venous blood glucose≥7.8 mmol/L,and 21.00%had glycosylated hemoglobin≥6.5%.Conclusion There is significant difference in the distribution of venous blood glucose levels in different populations.Patients in emergency room and ICU have higher abnormal blood glucose rate.Therefore,it is necessary to improve the individualized diagnosis and treatment scheme and improve the blood glucose intervention mechanism in order to facilitate the comprehensive clinical management.