血糖水平对ICU危重症患者感染及预后的影响

摘要

目的 探讨不同血糖水平对ICU危重症患者感染及预后的影响. 方法 将104例空腹血糖(FBG)升高的(FBG>6.1mmol/L)ICU危重症患者按FBG值分为A组(6.1 mmol/L10.0mmol/L,n=46),对照分析2组患者的感染状况及预后. 结果 B组的感染发生率和死亡率为60.87%和43.48%, 明显高于A 组的37.93%和 20.69%(P<0.05), 但 2 组的 MODS 发生率差异无统计学意义 (P>0.05),B 组呼吸系统感染发生率为50.00%,明显高于A组的31.03%(P<0.05). B组G-菌的感染率为34.78%,明显高于A组的17.24%(P<0.05),2组G+菌和真菌的感染率比较差异无统计学意义(P>0.05). 结论 ICU高血糖(FBG>10.0 mmol/L)患者的感染发生率,以G-菌感染为主,且预后较差,ICU患者的FBG最好控制在10.0 mmol/L以下.%Objective To study the effect of different blood glucose levels on prognosis and infection of stress hyperglycemia patients in the ICU. Methods 104 cases stress hyperglycemia patients with high fasting blood glucose (FBG>6.1mmol/L)in the ICU were divided into group A(6.1 mmol/L< FBG<10.0 mmol/L,n=58)and group B(FBG>10.0 mmol/L,n=46)by FBG value,contrast analysis the infection status and prognosis of two groups patients. Results The infection rate and mortality rate of group B were 60.87% and 43.48%,were significantly higher than 37.93% and 20.69% of group A (P<0.05),but the MODS rate was no statistical difference between group A and group B (P>0.05),the infection rate of respiratory system of group B was 47.82%,that was ignificantly higher than 31.03%of group A(P<0.05). The G- bacteria infection rate of group B was 34.78%,that was ignificantly higher than 17.24 of group A (P<0.05),G+ bacteria infection rate and fungi nfection ratewere no statistical difference between group A and group B (P>0.05). Conclusion ICU patients with high blood glucose (FBG>10.0 mmol/L) have higher infection incidenc and mortality rates,and the prognosis is poorer,FBG had better control under tendency for 10.0 mmol/L in ICU patients.