|本期目录/Table of Contents|

[1]朱正国,刘飞,徐非凡.早期血糖水平波动评估呼吸机相关性肺炎合并高血糖患者的预后价值[J].医学研究与战创伤救治(原医学研究生学报),2018,20(05):519-522.[doi:10.3969/j.issn.1672-271X.2018.05.016]
　ZHU Zheng-guo,LIU Fei,XU Fei-fan.Relationship between the early glucose variability and the prognosis in ventilator-associated pneumonia patients with hyperglycemia[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(05):519-522.[doi:10.3969/j.issn.1672-271X.2018.05.016]
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早期血糖水平波动评估呼吸机相关性肺炎合并高血糖患者的预后价值()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第20卷
期数:
2018年05期
页码:
519-522
栏目:
临床研究
出版日期:
2018-09-18

文章信息/Info

Title:
Relationship between the early glucose variability and the prognosis in ventilator-associated pneumonia patients with hyperglycemia
作者:
朱正国; 刘飞; 徐非凡
作者单位：247100池州，池州市人民医院重症医学科（朱正国、刘飞、徐非凡）
Author(s):
ZHU Zheng-guo; LIU Fei; XU Fei-fan
（Department of Intensive Medicine，the People′s Hospital of Chizhou，Chizhou 247100，Anhui，China）
关键词:
血糖波动; 呼吸机相关性肺炎; 高血糖; 预后
Keywords:
glucose variability; ventilator-associated pneumonia; hyperglycemia; prognosis
分类号:
R563.1
DOI:
10.3969/j.issn.1672-271X.2018.05.016
文献标志码:
A
摘要:
目的 探讨早期血糖水平波动与呼吸机相关性肺炎（VAP）合并高血糖患者预后的关系，为VAP合并高血糖患者预后预测提供临床依据。方法 收集2014年1月至2016年12月在安徽省池州市人民医院ICU住院期间被诊断为VAP合并高血糖的42例患者资料，根据患者生存情况分为生存组（n=20）和死亡组（n=22），计算并比较2组间48 h内指尖末梢血初始血糖、平均血糖、血糖标准差、血糖变异系数、最大血糖波动幅度、平均血糖波动幅度、血糖不稳定指数等血糖波动指标；采用受试者工作曲线分析血糖波动指标对VAP合并高血糖患者预后预测价值。结果 2组间初始血糖、血糖变异系数差异无统计学意义（P＞0.05），死亡组较生存组平均血糖[（10.07±2.94）mmol/L vs (8.83±1.53) mmol/L]、血糖标准差[（2.61±0.76） vs (2.21±0.73）]、最大血糖波动幅度[（10.45±2.58）mmol/L vs (8.53±1.69）mmol/L]、平均血糖波动幅度[（4.95±1.79）mmol/L vs (3.91±1.78）mmol/L]和血糖不稳定指数[（24.14±9.99 vs (14.59±8.70）]显著升高(P<0.05)；血糖不稳定指数和最大血糖波动幅度预测VAP合并高血糖患者预后的曲线下面积分别为0.781和0.726。结论 早期血糖波动水平可用于VAP患者的预后评估，其中血糖不稳定指数和最大血糖波动幅度对预测VAP合并高血糖患者的预后具有一定的价值。
Abstract:
Objective To investigate the relationship between the early glucose variability and the prognosis in ventilator-associated pneumonia(VAP) patients with hyperglycemia.Methods Patients diagnosed as VAP with hyperglycemia were collected in ICU of People′s Hospital of Chizhou from January 2014 to December 2016. These cases were divided into survival group and death group according to the prognosis of patients. The indexes of glucose variability including glucose at admission, average glucose, standard deviation of glucose, coefficient variation of glucose, maximum fluctuation of glucose, mean amplitude of glucose excursion and glycemic lability index were calculated and compared between two groups. The predictive value of glucose variability on the prognosis of patients with VAP combined with hyperglycemia was analyzed by receiver operating curve.Results There was no significant difference in the glucose at admission and coefficient variation of glucose between the survival group (n=20) and the death group (n=22) (P>0.05). The average glucose [（10.07±2.94）mmol/L vs （8.83±1.53）mmol/L], standard deviation of glucose [（2.61±0.76） vs （2.21±0.73）], maximum fluctuation of glucose [（10.45±2.58）mmol/L vs （8.53±1.69）mmol/L], mean amplitude of glucose excursion [（4.95±1.79）mmol/L vs （3.91±1.78）mmol/L] and glycemic lability index[（24.14±9.99） vs （14.59±8.70）] in death groupwere higher than that of survival group(P<0.05). The area under the curve of glycemic lability index and maximum fluctuation of glucose to predicte the prognosis of VAP with hyperglycemia were 0.781 and 0.726 respectively.Conclusion Indicators of glucose variability could be used to evaluate the prognosis of VAP patients with hyperglycemia. The glycemic lability index and maximum fluctuation of glucose seem to be valuable in predicting the prognosis of VAP patients with hyperglycemia.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2018-09-20