血糖波动对2型糖尿病合并脓毒症患者预后的影响

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摘要目的探讨血糖波动对2型糖尿病合并脓毒症患者预后的影响。方法选取2021年3月—2023年3月在湖南省某三级医院治疗的125例2型糖尿病合并脓毒症的患者,根据28 天转归结局患者是否存活,分为非存活组31例与存活组94例两组。比较两组患者的空腹血糖（FBG）、餐后两小时血糖（2hPG）、糖化血红蛋白（HbA1c）、平均血糖、血糖标准差（SDBG）、餐后血糖波动幅度（PPGE）、最大血糖波动幅度（LAGE）、血糖变异系数（CV）、葡萄糖目标范围内时间（TIR）、急性生理和慢性健康状况（APACHEII）评分等指标是否存在差异;将平均血糖、SDBG、PPGE、LAGE、CV、TIR与APACHEII评分进行Spearman相关性分析。结果两组患者FBG、2hPG、HbA1c比较,差异无统计学意义;与存活组比较,非存活组患者APACHEII评分、平均血糖、SDBG、PPGE、LAGE、CV均高于存活组,TIR低于存活组;平均血糖、SDBG、LAGE与APACHEII评分呈正相关,TIR与APACHEII评分呈负相关;CV和PPGE与APACHEII评分无明显相关。结论血糖波动与糖尿病合并脓毒症患者的预后相关,会增加不良结局的风险。

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	易卓卓

关键词 ：血糖波动, 2型糖尿病, 脓毒症, 预后

Abstract：Objective To investigate the impact of blood glucose fluctuations on the prognosis of patients with type 2 diabetes mellitus (T2DM) and sepsis. Methods A total of 125 patients with T2DM and sepsis who were admitted to a tertiary hospital in Hunan Province from March 2021 to March 2023 were selected. Based on the 28-day outcome, the patients were divided into two groups: the non-survival group (n=31) and the survival group (n=94). fasting blood glucose (FBG), postprandial blood glucose at 2 hours (2hPG), glycated hemoglobin (HbA1c), mean blood glucose, blood glucose standard deviation (SDBG), postprandial blood glucose fluctuation amplitude (PPGE), maximum blood glucose fluctuation amplitude (LAGE), blood glucose coefficient of variation (CV), time in range (TIR), acute physiology and chronic health evaluation II (APACHE II) score, and other indicators were collected. The differences between the two groups were compared for statistical significance. Spearman correlation analysis was performed between mean blood glucose, SDBG, PPGE, LAGE, CV, TIR and APACHE II score. Results The FBG, 2hPG, and HbA1c levels were no significant difference between the two groups; Compared with the survival group, the non-survival group had higher APACHE II scores, mean blood glucose, SDBG, PPGE, LAGE, and CV, but lower TIR. There were significant differences between the two groups; Mean blood glucose, SDBG, and LAGE were positively correlated with APACHE II scores, while TIR was negatively correlated with APACHE II scores. There was statistical significance. CV and PPGE were not significantly correlated with APACHE II scores. Conclusion Blood glucose fluctuations are associated with the prognosis of patients with diabetes mellitus and sepsis, increasing the risk of adverse outcomes.

Key words： blood glucose fluctuation type 2 diabetes mellitus sepsis prognosis

收稿日期: 2023-12-20

中图分类号:

R587.1

基金资助:湖南省教育厅科研项目“SGLT-2抑制剂对2型糖尿病非增殖期视网膜病变的影响”（21C0025）

通讯作者: 李青,E-mail：1402598379@qq.com

引用本文:

龙蕾, 李青, 易卓卓. 血糖波动对2型糖尿病合并脓毒症患者预后的影响[J]. 湖南师范大学学报(医学版), 2024, 21(1): 95-98. LONG Lei, LI Qing, YI Zhuozhuo. Effects of blood glucose fluctuation on the prognosis of patients with type 2 diabetes mellitus and sepsis. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(1): 95-98.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2024/V21/I1/95

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