糖尿病酮症酸中毒住院患者的预后因素分析

发布时间：2018-05-30 17:06

  本文选题：糖尿病酮症酸中毒 + GCS评分　； 参考：《第三军医大学学报》2017年16期

【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(P0.05,P0.01),存活组APACHEⅡ评分[(8.58±4.63)vs(15.73±4.38)]、白细胞总数[(14.82±9.55)×10~9/L vs(22.80±7.67)×10~9/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(P0.05,P0.01)。DKA患者GCS评分(OR=0.510,P0.05)越低、APACHEⅡ评分(OR=1.300,P0.05)及C反应蛋白(OR=1.031,P0.05)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 of diabetic ketoacidosis (DKA) patients with diabetic ketoacidosis in order to improve the diagnosis and treatment of diabetic ketoacidosis and reduce the mortality. Methods the clinical data of DKA patients admitted to our hospital from January 2014 to December 2016 were collected. Patients with DKA were divided into survival group and death group according to their survival. The basic condition, blood routine, liver and kidney function, electrolytes C-reactive protein were analyzed retrospectively. Glasgow coma scale, acute physiology and chronic health 鈪，

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