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目的研究高血糖高渗性非酮症综合征死亡的危险因素及干预对策。方法总计40例高血糖高渗性非酮性综合征患者按生存与非生存分为二组。急性生理和慢性健康评估Ⅱ评分(APACHEⅡ)用于评估病情的严重程度;用 Logistic 回归分析确定高血糖高渗性非酮症综合征死亡的危险因素。结果平均血浆渗透压生存组(348.4±14.4 mOsm/L)明显低于非生存组(360.6±17.4 mOsm/L)(P<0.05)。平均 APACHEⅡ分值生存组(15.4±5.5分)明显低于非生存组(28.0±4.5分)(P<0.001)。两组的血浆渗透压与 APACHEⅡ分值为正相关(r=0.422 P<0.01)。多因素 Logistic 分析显示,血浆渗透压过高和昏迷与高血糖高渗性非酮症高渗综合征死亡有关联。结论血浆渗透压越高,病情就越重,病死率也越高。血浆渗透压过高和昏迷是高血糖高渗性非酮症高渗性综合征死亡的联合因素或独立因素,应重视针对其危险因素进行干预。
Objective To study the risk factors of hyperglycemia and hypertonic nonketotic syndrome and the intervention strategies. Methods A total of 40 patients with hyperglycemic hypertonic non-ketogenic syndrome were divided into two groups according to survival and non-survival. Acute Physiology and Chronic Health Evaluation II score (APACHE II) was used to assess the severity of the disease; Logistic regression analysis was used to determine the risk factors for hyperglycemic hypertonic non-ketotic syndrome death. Results The average plasma osmolality in survival group (348.4 ± 14.4 mOsm / L) was significantly lower than that in non-survival group (360.6 ± 17.4 mOsm / L) (P <0.05). The average APACHE II score survival group (15.4 ± 5.5) was significantly lower than the non-survival group (28.0 ± 4.5) (P <0.001). The two groups of plasma osmolality and APACHE Ⅱ score was positively correlated (r = 0.422 P <0.01). Multivariate Logistic analysis showed that plasma osmolality and coma were associated with death from hyperglycemic hyperosmolar nonketotic hypertonic syndrome. Conclusion The higher the plasma osmotic pressure, the heavier the disease, the higher the case fatality rate. High plasma osmolality and coma are hypertensive hyperosmolar nonketotic hypertonic syndrome death combined with or independent factors, should pay attention to its risk factors for intervention.