急性胰腺炎合并糖尿病患者的临床特征及血糖代谢与病情严重度的相关性

Clinical characteristics and correlation between blood glucose metabolism and severity of acute pancreatitis with diabetes

目的探讨急性胰腺炎合并糖尿病患者的临床特征及血糖代谢与病情严重度的相关性。方法回顾性收集长春市中心医院2020年1月至2022年12月收治的急性胰腺炎患者268例,根据患者既往是否存在糖尿病,将患者分为糖尿病组(n=90)和非糖尿病组(n=178),比较两组患者病情严重度和血糖代谢情况,分析血糖代谢情况与急性胰腺炎患者病情严重度的相关性。结果与非糖尿病组比较,糖尿病组患者SOFA≥4分的患者比例显著增高(11.11%比3.93%,P=0.023);SAP的比例显著增高(31.11%比15.17%,P=0.002);需要外科引流的患者比例更高(31.11%比15.17%,P=0.002);空腹血糖显著升高(9.35±1.06 mmol/L比5.38±0.82 mmol/L,P=0.000);糖化血红蛋白显著升高(8.31%±1.41%比5.00%±1.14%,P=0.000)。糖化血红蛋白对合并糖尿病的急性胰腺炎患者发展至重症急性胰腺炎具有较好的预测价值,曲线下面积为0.828,95%CI0.736~0.919,P=0.000。空腹血糖、糖化血红蛋白与SOFA评分呈正相关性(r=0.285,P=0.006;r=0.219,P=0.038)。结论糖尿病是急性胰腺炎患者病情加重的一个预测指标,控制血糖代谢,可能有利于改善急性胰腺炎患者预后。

Objective To study the clinical characteristics and the correlation between blood glucose metabolism and severity of acute pancreatitis with diabetes.Methods A total of 268 patients with acute pancreatitis admitted to Changchun Central Hospital from January 2020 to December 2022 were retrospectively collected.According to whether the patients had diabetes before,the patients were divided into diabetes group(n=90)and non diabetes group(n=178).The severity and blood glucose metabolism of the two groups were compared,and the correlation between blood glucose metabolism and the severity of acute pancreatitis was analyzed.Results Compared with the non diabetes group,the proportion of patients with SOFA≥4 in the diabetes group was significantly higher(11.11%vs.3.93%,P=0.023);The proportion of patients required surgical drainage significantly increased(31.11%vs.15.17%,P=0.002);The fasting blood glucose significantly increased[(9.35±1.06)mmol/L vs.(5.38±0.82)mmol/L,P=0.000];Glycated hemoglobin significantly increased[(8.31±1.41)%vs.(5.00±1.14)%,P=0.000].Glycated hemoglobin had a good predictive value for patients with acute pancreatitis complicated with diabetes to develop to severe acute pancreatitis.The area under the curve was 0.828,95%CI:0.736-0.919,P=0.000.There was a positive correlation between fasting blood glucose,glycated hemoglobin and SOFA score(r=0.285,P=0.006;r=0.219,P=0.038).Conclusion Diabetes is a predictive index for the aggravation of acute pancreatitis.Controlling blood glucose metabolism may be helpful to improve the prognosis of patients with acute pancreatitis.