上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (6): 832-.doi: 10.3969/j.issn.1674-8115.2011.06.034

• 论著（临床研究） • 上一篇    下一篇

住院患者入院空腹血糖水平与病情转归的关系研究

胡一鸣, 任 颖, 邵 琦, 杜冬梅, 张 倩, 赵催春   

  1. 上海交通大学附属第六人民医院特需病房 上海市糖尿病临床医学中心, 上海 200233
  • 出版日期:2011-06-28 发布日期:2011-06-27
  • 通讯作者: 任 颖, 电子信箱: renying@sjtu.edu.cn。
  • 作者简介:胡一鸣 (1983—), 男, 硕士生；电子信箱: tony_1029@hotmail.com。

Relationship between fasting blood glucose at admission and outcomes in hospitalized patients

HU Yi-ming, REN Ying, SHAO Qi, DU Dong-mei, ZHANG Qian, ZHAO Cui-chun   

  1. Department of Special Medical Service, Shanghai Clinical Centre for Diabetes, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
  • Online:2011-06-28 Published:2011-06-27

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摘要：

目的 分析住院患者入院空腹血糖水平与其病情转归的关系。方法 对2006—2009年住院患者(n=186 192)的病史资料进行筛查，剔除糖尿病确诊患者，选取入院次日接受空腹血糖检测且发生院内死亡的患者作为死亡病例组（n=1 731），按照国际疾病分类标准(ICD—10)的要求设立匹配对照组(n=1 731)。对患者入院空腹血糖水平与院内病死率及其住院费用的关系进行统计学分析。结果 死亡病例组患者的入院平均空腹血糖水平及住院总费用均显著高于对照组（P<0.05）; 入院空腹血糖为5.0~7.9 mmol/L患者人群的院内病死率和住院费用最低，入院血糖空腹血糖水平低于5.0 mmol/L或高于7.9 mmol/L患者的院内病死率显著升高（P<0.01），且患者的住院费用也明显增加；当入院空腹血糖值低于3.0 mmol/L时，患者院内死亡的风险最高，优势比（OR值）为1.67， 95%可信区间（CI）为1.42~1.98（P<0.01）。校正年龄、性别和主要诊断疾病分类后，入院空腹血糖水平是患者发生院内死亡的独立危险因素， OR值为1.486，95%CI为1.423~1.552（P<0.001)。结论 入院空腹血糖水平是住院患者发生院内死亡的独立危险因素，低血糖患者发生院内死亡的风险可能更大。

关键词: 住院患者, 空腹血糖, 院内病死率, 住院费用

Abstract:

Objective To investigate the relationship between fasting blood glucose at admission and outcomes in hospitalized patients. Methods The clinical data of 186 192 hospitalized patients between 2006 and 2009 were screened, and patients confirmed with diabetes were excluded. Patients who received fasting blood glucose measurement on the second day of admission and died in hospital were selected as death case group (n=1 731), and 1 731 matched controls were recruited according to International Classification of Diseases (ICD-10). The associations of fasting blood glucose at admission with hospital mortality and hospital cost were statistically analysed. Results The fasting blood glucose at admission and hospital cost in death case group were significantly higher than those in control group (P<0.05). Patients with fasting blood glucose at admission of 5.0 mmol/L to 7.9 mmol/L had the lowest hospital mortality and hospital cost, while the hospital mortalities of those with fasting blood glucose at admission lower than 5.0 mmol/L or 7.9 mmol/L significantly increased (P<0.01), and the hospital cost also markedly increased. The risk of hospital mortality was the highest when fasting blood glucose at admission was lower than 3.0 mmol/L, with odds ratio (OR) of 1.67 and 95% confidence interval (CI) of 1.42 to 1.98 (P<0.01). Fasting blood glucose at admission was independent risk factor for hospital mortality after adjustment by age, sex and ICD (OR=1.486，95%CI =1.423 to 1.552)（P<0.001). Conclusion Fasting blood glucose at admission is independent risk factor for hospital mortality in hospitalized patients, and hypoglycemia may be more risky for hospital mortality.

Key words: hospitalized patients, fasting glucose, hospital mortality, hospital cost