·糖尿病临床研究·

　　【摘要】 目的 探讨重症监护病房(ICU)患者血糖变异度与预后的相关性。方法 选取ICU患者223例，根据预后分为存活组145例和死亡组78例。比较两组急性生理学和慢性健康状况(APACHE)Ⅱ评分、感染相关器官功能衰竭评分系统(SOFA)评分、血肌酐(Scr)、HbA1c、血脂、平均血糖(GLUave)、血糖标准差(GLUsd)、血糖变异系数(GLUcv)和低血糖发生率。 结果 两组GLUave比较差异无统计学意义，死亡组年龄、APACHEⅡ评分、SOFA评分、GLUsd、GLUcv和低血糖发生率高于存活组(P<0.05)。Logistic多元回归分析显示，年龄、APACHEⅡ评分、SOFA评分、GLUcv和低血糖发生率是影响预后的独立因素。受试者工作特征(ROC)曲线显示，GLUcv预测病死率敏感性与APACHEⅡ评分相当。 结论 GLUcv是影响ICU患者预后的独立因素，可作为其预后的预测因子。

　　【关键词】血糖变异度;重症监护病房;预后

The relationship between glucose variability and prognosis in intensive care unit patients CHEN Zhao-yan, LUO Zuo-jie, QIN Ying-fen, et al. Department of Intensive Care Unit, The First Affiliated Hostipal of Guangxi Medical University, Nanning 530021, China

Corresponding author:LUO Zuo-jie, E-mail:zluo888@163.com

　　【Abstract】 Objective To investigate the relationship of glucose variability and prognosis in patients of intensive care unit (ICU). Methods The 223 patients in ICU were divided into the ICU survival group 115 patients and the ICU nonsurvival group 78 patients. Acute physiology and chronic health evaluation (APACHE)Ⅱ score, Sepsis-related Organ Failure Assessment (SOFA) score, creatinine, HbA1c, lipids, mean blood glucose concentration (GLUave), standard deviation of glucose (GLUsd), coefficient of glucose variability (GLUcv), and events of hypoglycemia were compared between two groups. Results There was no statistically difference in GLUave between two groups. The age, APACHEⅡ score, SOFA score, GLUsd, GLUcv and events of hypoglycemia were higher in nonsurvival group than in survival group (P<0.05). Logistic regression analysis identified the following factors affecting prognosis, the age, APACHEⅡ score, SOFA score, GLUcv and events of hypoglycemia. ROC curve indicated that GLUcv could sensitively predict mortality as well as APACHEⅡ score. Conclusion GLUcv is an independent factor affecting prognosis. It may be as a predictor for mortality in ICU patients.

　　【Key words】Glucose variability;Intensive care units (ICU);Prognosis