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没有糖尿病的严重低血糖住院的预后因素:一项回顾性研究
Taito Miyoshi1, Tetsuya Yamada2, Kazuki Ota1
1Department of Diabetes and Endocrinology, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa Japan.
非糖尿病低血糖症的预后不好. 低估计的淋巴膜过率 (eGFR) 与死亡有关,而较高的血糖,白蛋白和酒精摄入量可以改善这些患者的生存率.
科学领域:
- 内分泌学和新陈代谢学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内部医学 内部医学
背景情况:
- 与糖尿病性低血糖症相比,非糖尿病性低血糖症的预后更差.
- 非糖尿病低血糖症的预后因素尚未明确,需要进一步调查.
研究的目的:
- 为了确定与非糖尿病低血糖症住院患者的死亡相关的关键预后因素.
- 调查非糖尿病低血糖的潜在原因和临床特征.
主要方法:
- 对126名患有严重非糖尿病低血糖症 (血糖≤3.0mmol/L) 的住院患者的回顾性分析.
- 识别常见原因,包括营养不良,酒精摄入量和低温.
- 多变量分析以确定与90天死亡率和生存率独立相关的因素.
主要成果:
- 营养不良 (62.7%),酒精摄入 (21.4%) 和低温 (21.4%) 是最常见的原因.
- 很大一部分患者 (60.3%) 患有多种促成因素.
- 低估计的淋巴膜过率 (eGFR < 30 mL/min/1.73 m2) 独立地与90天死亡率的增加有关 (OR 5.78).
- 较高的血糖 (OR 0.95),血清白蛋白 (OR 0.27) 和酒精摄入量 (OR 0.03) 与改善的生存率有关.
结论:
- 非糖尿病低血糖症与高死亡率有关.
- 降低eGFR,降低血糖,以及在入院时降低血清白蛋白水平是90天死亡率的关键指标.
- 在这个患者队列中,酒精摄入似乎是生存的保护因素.
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