摘要
目的:根据区域内的糖尿病流行病学和糖尿病防治管理现状,利用信息化技术手段,通过患者血糖大数据分析,评价住院糖尿病患者血糖变化趋势,了解住院患者血糖监控的薄弱环节,从而指导临床血糖管理。方法:基于多中心的信息化血糖管理平台,于2016年9月至2018年1月收集重庆医科大学附属永川医院、重庆医科大学附属第二医院、重庆三峡中心医院共10608例住院糖尿病患者床旁血糖数据,采用群体模型(population model)、个体模型(patient model)、人-时模型(patient-day model)分析住院糖尿病患者的血糖构成比:高血糖、低血糖、理想血糖占比等情况。结果:共收集快速床旁监测(point-of-care testing,POCT)血糖数据253738个,采用群体模型分析,高血糖达38.3%,理想血糖仅占20.5%;采用个体模型分析,住院期间曾发生低血糖的患者占13.2%,其中曾出现严重低血糖的患者占1.2%,发生严重低血糖患者为低血糖患者的9.4%;采用人-时模型分析,理想血糖的患者人时数为49.6%,高血糖发生率为60.2%,严重高血糖发生率为18.8%。结论:住院糖尿病患者的理想血糖占比低,高血糖占比高,经过一段时间住院治疗后高血糖发生率呈下降趋势,但传统内分泌科被动会诊模式导致部分高血糖事件处理不及时。所有时间段均发生了低血糖事件,且部分患者发生了严重低血糖事件,午餐前与空腹为高发时段,晚餐前血糖监测频次低。
Objective:To evaluate the blood glucose changes in hospitalized patients with diabetes by big data analysis of patients using information technology according to the epidemiology of diabetes and the current status of prevention,treatment,and management of diabetes in the region,to understand the weak links of monitoring hospitalized patients'blood glucose,and to guide clinical blood glucose management.Methods:Based on a multicenter informationized blood glucose management platform,from September 2016 to January 2018,the bedside blood glucose data of 10608 hospitalized patients with diabetes were collected from the Yongchuan Hospital of Chongqing Medical University,The Second Affiliated Hospital of Chongqing Medical University,and the Chongqing Three Gorges Central Hospital.The population model,patient model,and patient-day model were used to analyze the blood glucose constituent ratio of inpatients with diabetes:proportions of patients with hyperglycemia,hypoglycemia,and ideal blood glucose level.Results:A total of 253738 point-of-care testing blood glucose monitoring data were collected.The population model analysis showed that the prevalence of hyperglycemia reached 38.3%,and the individuals with an ideal blood glucose level only accounted for 20.5%.The patient model analysis showed that 13.2%of the patients had hypoglycemia during hospitalization;patients with severe hypoglycemia accounted for 1.2%;patients with severe hypoglycemia accounted for 9.4%of patients with hypoglycemia.The patient-day model analysis showed that the patients with an ideal blood glucose level accounted for 49.6%;the incidence of hyperglycemia was 60.2%;the incidence of severe hyperglycemia was 18.8%.Conclusion:The proportion of hospitalized diabetes patients with an ideal blood glucose level is low,and the proportion of those with hyperglycemia is high.After a period of hospitalization,the incidence of hyperglycemia is decreasing,but the traditional endocrinology passive consultation mode causes that some hyperglycemia events are not managed in time.Hypoglycemia events occur in all time periods,and some patients have severe hypoglycemia events.The high-risk periods of hypoglycemia are before lunch and fasting.The frequency of blood glucose monitoring before dinner is low.
作者
周蒙蒙
龚放
赵锡丽
杨刚毅
李志勇
杨增群
陈艳
Zhou Mengmeng;Gong Fang;Zhao Xili;Yang Gangyi;Li Zhiyong;Yang Zengqun;Chen Yan(Department of Endocrinology,the Second Affiliated Hospital of Chongqing Medical University;Department of Endocrinology,the Yongchuan Hospital of Chongqing Medical University;Department of Endocrinology,Shizhu Branch,the Second Affiliated Hospital of Chongqing Medical University)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2020年第3期415-419,共5页
Journal of Chongqing Medical University
基金
重庆市卫计委科研资助项目(编号:2016ZDXMO21、2017MSXM201)。
关键词
糖尿病
血糖监测
血糖管理
高血糖
低血糖
diabetes
blood glucose monitoring
blood glucose management
hyperglycemia
hypoglycemia
