文章摘要
谭清武,徐海涛,唐静怡,李庆华,范艳平,李志颖.老年糖尿病肺部感染患者空腹血糖变化作为肺部感染致老年多器官功能不全综合征诊断指标的可行性研究[J].中国临床保健杂志,2018,21(1):7-9.
老年糖尿病肺部感染患者空腹血糖变化作为肺部感染致老年多器官功能不全综合征诊断指标的可行性研究
Feasibility study of changes of fasting blood glucose as a diagnostic index of MODSE in elderly diabetic with pulmonary infection
投稿时间:2017-06-16  
DOI:10.3969/J.issn.1672-6790.2018.01.003
中文关键词: 糖尿病  呼吸道感染  多器官功能衰竭  血糖
英文关键词: Diabetes  Respiratory tract infections  Lung diseases  Blood Glucose 〖FL
基金项目:河北省卫生计生委2014年医学科学研究重点课题(ZD20140316)
作者单位E-mail
谭清武 中国人民解放军白求恩国际和平医院干部病房,石家庄 050082 tanqw55108@163.com 
徐海涛 中国人民解放军白求恩国际和平医院干部病房,石家庄 050082  
唐静怡 中国人民解放军白求恩国际和平医院干部病房,石家庄 050082  
李庆华 中国人民解放军白求恩国际和平医院干部病房,石家庄 050082  
范艳平 中国人民解放军白求恩国际和平医院干部病房,石家庄 050082  
李志颖 中国人民解放军白求恩国际和平医院干部病房,石家庄 050082  
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中文摘要:
      目的 探讨老年糖尿病肺部感染患者的空腹血糖变化作为肺部感染致老年多器官功能不全综合征(MODSE)诊断指标的可行性。方法 对196例≥65岁的糖尿病肺部感染病例进行回顾性调查,所有病例按肺部感染是否诱发MODSE分为MODSE组(n=89)和非MODSE组(n=107),比较两组患者肺部感染后最高空腹血糖水平的差异。绘制老年糖尿病肺部感染患者最高空腹血糖水平受试者工作特征(ROC)曲线,计算ROC曲线下面积、以及不同空腹血糖水平对MODSE诊断的敏感度和特异度,确定诊断肺部感染致MODSE的最佳空腹血糖阈值。结果 MODSE组最高空腹血糖水平(13.720±4.863)mmol/L显著高于非MODSE组(7.439±3.043)mmol/L(t=10.580,P <0.001);老年糖尿病肺部感染患者最高空腹血糖水平ROC曲线下面积为0.900,面积的95%可信区间为0.857~0.943(P <0.001),取空腹血糖8.83 mmol/L时,诊断肺部感染致MODSE的敏感度和特异度均较为理想、分别为86.5%和81.3%。结论 老年糖尿病肺部感染患者的空腹血糖变化对肺部感染致MODSE具有诊断价值、作为肺部感染致MODSE的诊断指标具有可行性。空腹血糖≥8.83 mmol/L可作为一项诊断指标纳入肺部感染致MODSE的诊断。
英文摘要:
      Objective To explore the feasibility of changes of fasting blood glucose as a diagnostic index of MODSE in elderly diabetic with pulmonary infection .Methods A retrospective study was carried out on 196 diabetic over 65 years old with pulmonary infection.All patients were divide into MODSE group(n=89) and non MODSE group(n=107) according to the onset of MODSE induced by pulmonary infection.The highest fasting blood glucose of two groups were compared.The ROC curve of the highest fasting blood glucose of elderly diabetic with pulmonary infection was drawn,and the area under the ROC curve was calculated.The diagnostic accuracy of different fasting blood glucose were assessed using sensitivity and specificity,and the optimal diagnosis point for MODSE was found.Results The highest fasting blood glucose of MODSE group was significantly higher than the non MODSE group[(13.720±4.863) mmol/L VS.(7.439±3.043) mmol/L,t=10.580,P<0.01].The area under the ROC curve was 0.900,and 95% CI was 0.857-0.943(P<0.01).When taking the fasting blood glucose 8.83 mmol/L,the sensitivity was 86.5%,the specificity was 81.3%.Conclusion The change of fasting blood glucose in elderly diabetic with pulmonary infection has diagnostic value for MODSE.Fasting blood glucose more than 8.83mmol/L can be used as a diagnostic index in diagnosis of MODSE in elderly diabetic patients with pulmonary infection.
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