[1]张春林,刘刚,童强,等.糖尿病酮症酸中毒住院患者的预后因素分析[J].第三军医大学学报,2017,39(16):1659-1663.
 ZHANG Chunlin,LIU Gang,TONG Qiang,et al.Prognostic factors in hospitalized patients with diabetic ketoacidosis[J].J Third Mil Med Univ,2017,39(16):1659-1663.
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糖尿病酮症酸中毒住院患者的预后因素分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
39卷
期数:
2017年第16期
页码:
1659-1663
栏目:
临床医学
出版日期:
2017-08-30

文章信息/Info

Title:
Prognostic factors in hospitalized patients with diabetic ketoacidosis
作者:
张春林刘刚童强张瑞
第三军医大学新桥医院:内分泌科,呼吸内科
Author(s):
ZHANG Chunlin LIU Gang TONG Qiang ZHANG Rui

Department of Endocrinology, Department of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China

关键词:
糖尿病酮症酸中毒GCS评分APACHEⅡ评分预后因素
Keywords:
diabetic ketoacidosis Glasgow coma scale acute physiology and chronic health evaluation prognostic factors
分类号:
R181.32;R587.1;R587.2
文献标志码:
A
摘要:

目的     回顾性分析糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)患者预后相关因素,以期提高DKA诊治水平及降低病死率。方法     收集本院内分泌科2014年1月至2016年12月收治的DKA住院患者临床资料。根据DKA患者是否存活分为存活组和死亡组,并回顾性分析2组患者基本情况、入院时血常规、肝肾功、电解质、C反应蛋白、格拉斯哥昏迷评分(Glasgow coma scale,GCS)、急性生理与慢性健康评分Ⅱ(acute physiology and chronic health evaluation scoreⅡ,APACHEⅡ)等观察指标及预后情况。结果     共纳入患者70例,其中男性36例,女性34例,年龄(42.63±15.67)岁。经统计分析结果显示,存活组患者GCS评分[(14.41±1.42)vs(11.36±3.14)]、血磷[(0.96±0.47)mg/L vs(068±0.60)mg/L]明显高于死亡组(P<0.05,P<0.01),存活组APACHEⅡ评分[(8.58±4.63)vs(15.73±4.38)]、白细胞总数[(14.82±9.55)×109/L vs(22.80±7.67)×109/L]、C反应蛋白[(33.67±45.70)mg/L vs(211.39±173.93)mg/L]、 肌酐[(87.28±43.89)μmol/L vs(136.47±87.50)μmol/L]、尿素氮[(8.45±5.00)mmol/L vs(14.72±9.23)mmol/L]明显低于死亡组(P<0.05,P<0.01)。DKA患者GCS评分(OR=0.510,P<0.05)越低、APACHEⅡ评分(OR=1.300,P<0.05)及C反应蛋白(OR=1.031,P<005)越高,预后则越差。结论     C反应蛋白、GCS评分、APACHEⅡ评分是DKA患者独立的预后因素。

Abstract:

Objective     To retrospectively analyze the prognostic factors for diabetic ketoacidsis (DKA) in order to improve the diagnosis and treatment and decreased the mortality for DKA. Methods     Clinical data of all DKA patients admitted in our department of endocrinology from January 2014 to December 2016 were collected and retrospectively analyzed. The patients were divided into the survival group and dead group. The baseline data, blood routine results, liver and renal functions, electrolyte levels, C-reactive protein (CRP) level, Scores of Glasgow coma scale (GCS) and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ),and prognosis of the DKA patients were analyzed. Results     There were totally 70 subjects enrolled, including 36 males and 34 females, at an average age of 42.63±15.67 years. When compared with the dead group, the survival group had significantly higher GCS score (14.41±1.42 vs 11.36±3.14) and serum phosphate (0.96±0.47 vs 0.68±0.60 mg/L), but obviously lower APACHEⅡ score (8.58±4.63 vs 15.73±4.38), white blood cells count [(22.80±7.67)×109/L vs (14.82±9.55)×109/L], CRP level (211.39±173.93 vs 33.67±45.70 mg/L), serum creatinine (136.47±87.50 vs 87.28±43.89 μmol/L), and urea nitrogen (14.72±9.23 vs 8.45±5.00 mmol/L)(all P<0.05, P<0.01). The lower the GCS score was (OR=0.510, P<0.05) and the higher APACHEⅡ score (OR=1.300, P<0.05) and CRP level (OR=1.031, P<0.05) were, the worse the prognosis was in the DKA patients. Conclusion    CRP level, GCS score and APACHEⅡ score are independent prognostic factors for DKA patients.

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更新日期/Last Update: 2017-08-23