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住院患者的血糖变化与COVID-19死亡率之间的关联:一项前性研究
Salma Ali El Chab Parolin1, Rebecca Benicio Stocco2, Julia do Carmo Kneipp Lopes2
1Pontifical Catholic University of Paraná (PUCPR), Rua Imaculada Conceição, 1155, Curitiba, Paraná, 80215-901, Brazil. salmacp@yahoo.com.br.
高血糖变异性,血糖波动的衡量标准,在住院COVID-19患者中显著增加死亡风险. 这种关联对于患有和没有糖尿病的人来说都是正确的,这突显了它在重症监护中的重要性.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 患有2019年新冠病毒病 (COVID-19) 的住院患者面临着显著的死亡风险.
- 血糖变化 (GV) 越来越被认为是患者治疗结果的关键因素.
- 在COVID-19患者中,GV和死亡率之间的特定关联需要进一步阐明.
研究的目的:
- 研究住院COVID-19患者的血糖变化 (GV) 和死亡率之间的关系.
- 为了确定GV是否是死亡率的独立预测因素,无论糖尿病状况如何.
- 为了确定GV的切割值,表明死亡风险增加.
主要方法:
- 对628名确诊COVID-19的住院患者 (年龄大于18岁) 的前性分析.
- 使用从毛细血管葡萄糖测试的标准偏差 (SD) 和变化系数 (CV) 来测量GV.
- 根据年龄,性别,糖尿病和心血管疾病进行调整的后勤回归模型,以评估死亡率的相关性.
主要成果:
- 高GV,定义为SD≥44.7 mg/dL或CV≥27.5%,与死亡率的增加显著相关.
- 与高GV患者相比,高GV患者的死亡率高于低GV患者 (OR为SD2.99,CV为2.43;p<0.001).
- 这种关联无论糖尿病是否存在,都仍然显著.
结论:
- 高血糖变异性是COVID-19患者死亡的独立风险因素.
- 监测和管理GV可能对于改善住院COVID-19患者的治疗结果至关重要.
- 这些发现强调了血糖控制在危急疾病中超出平均葡萄糖水平的重要性.
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