【摘要】 目的:探讨老年2型糖尿病患者发生严重低血糖的危险因素。方法:收集306例老年2型糖尿病患者,分为严重低血糖组78例及对照组228例,对2组患者的相关数据进行统计学比较及多因素非条件Logistic回归分析。结果:低血糖组患者与对照组相比:2型糖尿病病程更长(P=0.03),心脑血管病相关药物联用率较高(P=0.04),二甲双胍使用率偏低(P=0.002),而胰岛素使用率及口服降糖药(OAD)与胰岛素联用率较高(P=0.005和0.034);生化指标方面该组患者白细胞计数及中性粒细胞比例偏高(P=0.021和0.007),血红蛋白偏低(P<0.001),肾功能相关指标均较高(P值均<0.05),低钾血症的发生率高(P=0.006)。多因素Logistic回归分析显示病程>10年,胰岛素使用及与OAD联用,果糖胺水平≤2.5mmol/L,血白细胞升高及肾功能受损可能与严重低血糖发生相关。结论:病程>10年,胰岛素使用及与OAD联用,果糖胺水平≤2.5mmol/L及肾功能受损可能为老年2型糖尿病患者发生严重低血糖的危险因素,且血白细胞升高与严重低血糖明显相关。在对此类患者进行降糖治疗时应对以上危险因素进行评估。更多还原

【Abstract】 Objective: To investigate the risk factors for occurrence of severe hypoglycemia in elderly patients with type 2 diabetes. Methods: A total of 306 cases of elderly patients with type 2 diabetes were divided into severe hypoglycemia group (78 cases) and control group (228 cases). The related data of patients in two groups were compared statistically, and conducted a non-conditional logistic regression analysis. Results: Compared with those of control group, patients in severe hypoglycemia group showed a longer course of type 2 diabetes mellitus (P=0.03), a higher rate of taking multiple cardio-cerebrovascular drugs (P=0.04), a lower rate of metformin administration(P=0.002) but more insulin application(P=0.005) and combination use with oral antidiabetic drugs(P=0.034). Further more, the severe hypoglycemia group also showed higher white blood cell count and/or neutrophil percentage (P values were 0.021 and 0.007, respectively), a lower level of hemoglobin (P<0.001), a higher rate of abnormal renal function (P<0.05) and higher incidence of hypokalemia (P=0.006). Logistic regression analysis indicated that a long disease course (>10 years), insulin application and combination use with oral antidiabetic drugs, relatively lower fructosamine levels (≤2.5mmol/L), incrased level of white blood cell count and renal impairment were related to severe hypoglycemia. Conclusions: Long disease course (>10 years), insulin application and combination use with oral antidiabetic drugs, relatively lower fructosamine levels (≤2.5mmol/L), increased white blood cell count and renal function impairment were likely to be the risk factors for occurrence of severe hypoglycemia in elderly patients with type 2 diabetic, and to which we should pay more attention to the assessment during antidiabetic therapy.更多还原