| 摘要: |
| ［摘要］ 目的 探讨重症监护病房（ICU）脓毒症患者早期血糖指标对生存预后的影响。方法 回顾性分析2018年1月至2024年1月廊坊市第四人民医院ICU收治的251例脓毒症患者的临床资料，根据患者的生存预后将其分为存活组（n=165）和死亡组（n=86）。比较两组一般临床资料、治疗相关指标、血糖指标。采用多因素logistic回归分析血糖指标对患者生存预后的影响。结果 与存活组比较，死亡组年龄较大，急性生理学和慢性健康评价（APACHE）Ⅱ评分、序贯器官功能衰竭评估（SOFA）评分更高，器官衰竭数更多，使用升压药物和接受肾脏替代治疗的人数比例更高，机械通气时间更长，血糖变异系数（CV）和应激性高血糖比值（SHR）更大，差异有统计学意义（P<0.05）。经校正一般临床资料、疾病严重程度及治疗相关指标后，多因素logistic回归分析结果显示，较高的SHR水平是ICU脓毒症患者发生死亡的危险因素（P<0.05），血糖CV对ICU脓毒症患者预后的影响不显著（P>0.05）。结论 较高的SHR水平是ICU脓毒症患者死亡的危险因素，值得临床医师关注。 |
| 关键词: 应激性高血糖比值 变异系数 脓毒症 重症监护病房 |
| DOI：10.3969/j.issn.1674-3806.2024.10.15 |
| 分类号:R 459.7 |
| 基金项目:廊坊市科技计划项目（编号：2023013026） |
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| Exploration on the influence of early blood glucose indicators on survival prognosis of sepsis patients in intensive care unit |
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ZUO Yanyan1, LI Yunwei2
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1.Department of Anesthesiology, Fourth People′s Hospital of Langfang, Hebei 065700, China; 2.Department of Emergency Medicine, Fourth People′s Hospital of Langfang, Hebei 065700, China
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| Abstract: |
| ［Abstract］ Objective To explore the influence of early blood glucose indicators on survival prognosis of sepsis patients in intensive care unit(ICU). Methods The clinical data of 251 patients with sepsis who were admitted to the ICU of Fourth People′s Hospital of Langfang from January 2018 to January 2024 were retrospectively analyzed. According to the patients′ survival prognosis, they were divided into survival group(n=165) and death group(n=86). The general clinical data, treatment-related indicators and blood glucose indicators were compared between the two groups. The influence of blood glucose indicators on survival prognosis of the patients was analyzed by using multivariate logistic regression. Results Compared with the survival group, the death group had older age, higher Acute Physiology and Chronic Health Evaluation(APACHE) Ⅱ scores, higher Sequential Organ Failure Assessment(SOFA) scores, more failing organs, higher proportion of patients receiving drugs for raising blood pressure and proportion of patients receiving renal replacement therapy, longer mechanical ventilation time, and greater coefficient of variation(CV) of blood glucose values and stress hyperglycemia ratio(SHR), and the differences were statistically significant(P<0.05). After adjusting for general clinical data, disease severity and treatment-related indicators, the results of multivariate logistic analysis showed that higher SHR level was a risk factor of death for sepsis patients in ICU(P<0.05), while CV of blood glucose values had no significant effect on prognosis of sepsis patients in ICU(P>0.05). Conclusion Higher SHR level is a risk factor of death for sepsis patients in ICU, which is worthy of clinicians′ attention. |
| Key words: Stress hyperglycemia ratio(SHR) Coefficient of variation(CV) Sepsis Intensive care unit(ICU) |
