目的：分析低血糖脑损伤的相关危险因素，为基层医院糖尿病患者发生低血糖脑损伤提出应对策略提供依据。方法：选取2012年2月-2015年12月本院收治的300例糖尿病发生低血糖患者作为研究对象，收集年龄、性别、糖尿病病程、降糖药使用情况、饮食是否规律、低血糖持续时间、血糖水平、高血压病程、低血糖发作频率、对低血糖危害知晓情况及开始干预时间等多个与脑损伤可能的相关因素，进行单因素和多因素Logistic回归分析。结果：300例低血糖患者中，发生脑损伤者48例，发生率为16.0%；对11个变量进行单因素分析，发现年龄、糖尿病病程、磺脲类或胰岛素使用量、低血糖持续时间、血糖水平、高血压病程、低血糖发作频率、对低血糖危害知晓情况及开始干预时间与低血糖脑损伤发生有关（P<0.05）；多因素Logistic回归分析结果示65岁及以上、糖尿病病程5年以上、过量使用磺脲类药物或胰岛素、低血糖持续≥6 h、血糖水平<2.2 mmol/L、高血压病程5年以上及低血糖每天发生2次以上均为低血糖脑损伤的危险因素，对低血糖危害知晓及开始干预时间≤30 min为低血糖脑损伤的保护因素。结论：糖尿病患者发生低血糖脑损伤的相关危险因素较多，基层医护人员应加强对患者的健康教育，提高其对低血糖的认知水平，对低血糖做到早发现早干预，以减少低血糖脑损伤的发生。%Objective:To analyze the risk factors of hypoglycemic brain injury and provide the basis for strategies of hypoglycemia brain injury in patients with diabetes in primary hospital.Method:From February 2012 to December 2015,300 cases of diabetic combined hypoglycemia were selected as the research objects, possible factors associated with brain injury include age,gender,duration of diabetes,rules of diet,duration of hypoglycemia,blood glucose level, hypertension duration,hypoglycemia seizure frequency,awareness of the risk of hypoglycemia and intervention time were collected,single factor and multi factor Logistic regression analysis were used.Result:A total of 48 cases (16.0%) of brain injury occurred in 300 cases of hypoglycemia.The single factor analysis founded that age,course of diabetes,use of sulfonylurea or insulin,duration time of hypoglycemia, blood glucose level,course of hypertension,frequency of hypoglycemia,knowledge of hypoglycemia and start time of intervention had something to do with hypoglycemic brain injury(P<0.05).Logistic regression analysis founded that age greater than or equal to 65 years old,course of diabetes more than 5 years,the excessive use of sulfonylurea or insulin,hypoglycemia lasted over 6 h,the blood glucose level less than 2.2 mmol/L, course of hypertension for more than 5 years and the incidence of hypoglycemia daily occurred more than 2 times were the risk factors of hypoglycemic brain injury,the knowledge of hypoglycemia and start time of intervention less than 30 min were the protective factors of hypoglycemic brain injury.Conclusion:There are many risk factors of hypoglycemic brain injury in patients with diabetes,the primary health care workers should strengthen health education to patients,improve the cognitive level of hypoglycemia,achieve early detection and early intervention to hypoglycemia,in order to reduce the incidence of hypoglycemic brain injury.
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