慢加急性肝衰竭患者低血糖发生现状及危险因素分析

doi:10.3761/j.issn.0254-1769.2022.07.013

摘要/Abstract

摘要：

目的了解慢加急性肝衰竭患者空腹血糖的临床特点,分析其发生空腹低血糖的危险因素,为临床早期识别和预防低血糖提供参考。方法回顾性分析2013年5月—2019年12月在广州市某三级甲等医院感染科住院的931例慢加急性肝衰竭患者的临床资料,描述慢加急性肝衰竭患者空腹血糖的情况,根据血糖结果分为低血糖组和非低血糖组,采用单因素及Logistic回归分析筛选低血糖发生的危险因素。结果 931例慢加急性肝衰竭患者中,399例（42.86%）发生低血糖,其中207例（51.88%）为轻度低血糖。Logistic回归分析结果显示,住院时间（OR=1.008）、凝血酶原时间（OR=1.022）、合并肝硬化（OR=1.745）是慢加急性肝衰竭患者发生低血糖的危险因素。结论慢加急性肝衰竭患者轻度低血糖发生率高,住院时间长、凝血酶原时间长、合并肝硬化的患者发生低血糖的风险较高,临床医护人员应密切关注高风险患者,加强血糖监测并及时干预,从而减少低血糖的发生。

关键词: 慢加急性肝衰竭, 低血糖, 空腹血糖, 危险因素, 护理

Abstract:

Objective To understand the clinical characteristics of fasting glucose in patients with acute-on-chronic liver failure（ACLF）,and to analyze the risk factors of fasting hypoglycemia,to provide reference values that can help with the early clinical recognition and prevention of hypoglycemia. Methods The clinical data of 931 patients with ACLF hospitalized from May 2013 to December 2019 in the department of infectious diseases of a tertiary hospital in Guangzhou city,were retrospectively analyzed. ACLF patients were divided into hypoglycemic and non-hypoglycemic groups according to the fasting blood glucose levels. The demographics,clinical characteristics,comorbidities and laboratory indicators of patients in the 2 groups were compared,and the risk factors of hypoglycemia were obtained by Logistic regression analysis. Results There were 399 cases（42.86%） of hypoglycemia,including 207 cases（51.88%） of mild hypoglycemia. Binary Logistic regression analysis showed that the length of hospital stay（OR=1.008）,prothrombin time（OR=1.022） and cirrhosis（OR=1.745） were independent risk factors for hypoglycemia in patients with ACLF. Conclusion ACLF patients have a high incidence of mild hypoglycemia,longer hospital stays,longer prothrombin time,and cirrhosis which increase the risk of hypoglycemia. During clinical practice,more emphasis should be placed on screening high-risk patients via early assessment of their hypoglycemic risk,and hence provide timely interventions to reduce the occurrence of hypoglycemia.

Key words: Acute-on-Chronic Liver Failure, Hypoglycemia, Fasting Plasma Glucose, Risk Factors, Nursing Care

何娜, 江淑贤, 郑子梅, 周子惠, 纪湧芳, 陈妙霞, 李莉莉. 慢加急性肝衰竭患者低血糖发生现状及危险因素分析[J]. 中华护理杂志, 2022, 57(7): 846-852.

HE Na, JIANG Shuxian, ZHENG Zimei, ZHOU Zihui, JI Yongfang, CHEN Miaoxia, LI Lili. Status and risk factors of hypoglycemia in patients with acute-on-chronic liver failure[J]. Chinese Journal of Nursing, 2022, 57(7): 846-852.

图/表 3

表1 慢加急性肝衰竭不同分期患者的空腹血糖情况[例（百分比,%）]

Table 1 Fasting blood glucose levels in patients with different stages of acute-on-chronic liver failure[cases（percentage,%）]

表2 慢加急性肝衰竭患者发生低血糖的单因素分析

Table 2 Univariate analysis of hypoglycemia in patients with acute-on-chronic liver failure

表3 慢加急性肝衰竭患者发生低血糖危险因素的Logistic回归分析

Table 3 Risk factors for hypoglycemia in patients with acute-on-chronic liver failure logistic regression analysis

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