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分析 COPD 急性加重期患者 2 型糖尿病的患病率及预后。

Analysis of prevalence and prognosis of type 2 diabetes mellitus in patients with acute exacerbation of COPD.

机构信息

Department of Pulmonary and Critical Care Medicine, Institute of Respiratory Disease, The First Hospital of China Medical University, No. 155 Nanjing Street, North, Shenyang, 110001, China.

出版信息

BMC Pulm Med. 2021 Jan 6;21(1):7. doi: 10.1186/s12890-020-01371-9.

Abstract

BACKGROUND

For patients with acute exacerbation of COPD (AECOPD), type 2 diabetes mellitus (T2DM) as comorbidity have poor outcomes. However, data on the impact of previously diagnosed and new- diagnosed T2DM in such a patient population is lacking.

METHODS

Inpatients diagnosed with AECOPD in the department of Pulmonary and Critical Care Medicine of The First Hospital of China Medical University during 2011-2017 were enrolled. Data on demography, prevalence of type 2 DM, other comorbidities, hospital stays and laboratory tests (including arterial partial pressure of oxygen [PaO2]) results were recorded. Results were compared with AECOPD patients having previously diagnosed and new-diagnosed type 2 diabetes. Markers associated with development of type 2 DM and the prognosis of AECOPD patients were identified.

RESULTS

Of the 196 patients enrolled in this study, the overall prevalence of T2DM was 26%. The PaO2 in the newly diagnosed T2DM group was considerably lower versus non-diabetic group. The T2DM group had a longer hospital stay and higher troponin level versus the non-diabetic group. AECOPD patients with T2DM were found to be correlated with hypertension. Age, need for assisted ventilation, increased troponin, and elevated fasting blood glucose on admission were risk factors for death in hospitalized AECOPD patients.

CONCLUSIONS

AECOPD patients had a higher prevalence of T2DM than the general population; T2DM comorbidity caused lower PaO2, longer hospital stays, and increased troponin. Poor blood glucose control may increase the risk of death in AECOPD patients.

摘要

背景

对于急性加重期慢性阻塞性肺疾病(AECOPD)患者,合并 2 型糖尿病(T2DM)与较差的预后相关。然而,目前缺乏此类患者人群中既往诊断和新诊断 T2DM 的影响的数据。

方法

本研究纳入了 2011 年至 2017 年在中国医科大学第一附属医院呼吸与危重症医学科住院诊断为 AECOPD 的患者。记录了人口统计学、T2DM 患病率、其他合并症、住院时间和实验室检查(包括动脉血氧分压[PaO2])结果。将结果与患有既往诊断和新诊断 T2DM 的 AECOPD 患者进行比较。确定与 T2DM 发生和 AECOPD 患者预后相关的标志物。

结果

本研究纳入了 196 例患者,T2DM 的总体患病率为 26%。新诊断的 T2DM 组的 PaO2 明显低于非糖尿病组。T2DM 组的住院时间和肌钙蛋白水平均高于非糖尿病组。AECOPD 合并 T2DM 与高血压相关。年龄、需要辅助通气、肌钙蛋白升高和入院时空腹血糖升高是住院 AECOPD 患者死亡的危险因素。

结论

AECOPD 患者的 T2DM 患病率高于一般人群;T2DM 合并症导致 PaO2 降低、住院时间延长和肌钙蛋白升高。血糖控制不佳可能会增加 AECOPD 患者死亡的风险。

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