Effect of short term intensive glucose control for glucose variability and prognosis in severe infection combined with stress hyperglycemia
HUANG Zhigang
YE Min
WU Jiying
TAO Chunfang
ZHANG Caiming
Abstract：Objective To investigate the impact of short-term intensive glucose control on severe infections in pa-tients with stress hyperglycemia merger glucose variability ( GV) and prognosis.Methods Eighty-six patients with severe in-fection complicated stress hyperglycemia were randomly divided into intensive group ( blood glucose were 4.4-6.1 mmol /L) and the control group (8.0-10.0 mmol/L), 43 cases in each group.Observation group after admission’s 1,3,7 day’s T cell subsets ( CD4+, CD8+and CD4+/CD8+) and fasting plasma glucose ( FPG) changes were compared between the 2 groups, hypoglycemia and 28 days’ mortality analysis and prognosis were compared with multi-factor Logistic regression.Results In-tensive group’s 3,7 days’ CD4+, CD4+/CD8+were increased than those of the first day (at d3, t =2.42, t =2.06, at d7, t =4.85, t =4.69, P <0.05), which were significantly higher than the control group (at d3, t =2.71, t =2.05, at d7, t =5.64, t =2.32, P <0.05);blood glucose reached the normal level time of intensive group, after admission’s 3rd and 7th days’ FPG, GV, 28 days’ mortality was significantly lower than the control group ( t =7.28, t =23.07, t =24.31, t =0.18, t =5.47, P <0.05);2 group’s 1st day’s FPG, the incidence of hypoglycemia’s differences did not show statis-tically significant differences ( t =1.82, t =0.54, P >0.05); compared with survivors, death patients’ glucose standard time was prolonged, the 3rd days, 7th days’ FPG, APACHE II score and GV significantly higher ( OR =1.705, OR =1.889, OR =1.924, OR =1.436, OR =2.018, P <0.05);Logistic regression analysis showed that APACHE II and GV were independent risk factor for severe infection with stress hyperglycemia in death patients ( OR=1.990,95%CI 1.66 -2.38, P <0.01;OR =4.049,95% CI 1.870-8.750, P <0.01).Conclusion For patients with severe infections and stress hyperglycemia, short-term intensive blood glucose control can effectively control the infection, enhance immune func-tion, reduce blood sugar fluctuations and improve prognosis.
Keywords：Intensive glucose controlSevere infectionStress hyperglycemiaBlood sugar fluctuationsPrognosis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 582-585 )