【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。更多还原

【Abstract】 Objective To understand the clinical characteristics of fasting glucose in patients with acute-onchronic 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 931patients 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.更多还原