血糖差距作为心脏性休克的预后指标:一个回顾性队列研究
Qianqian Xu1, Jinsheng Wang1, Zhihui Lin1
1Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Xueyuanxi Road, No 109, Wenzhou , Zhejiang, 325027, China.
BMC cardiovascular disorders
|September 2, 2024
概括
血糖差距 (GG) 表明压力诱导的高血糖症,并预测心脏性休克 (CS) 患者的不良结果,无论糖尿病. 高GG水平与30天死亡率增加和CS中的乳酸水平相关.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
背景情况:
- 压力诱发的高血糖症 (SIH) 与心脏性休克 (CS) 的不良结果有关.
- 血糖差距 (GG),计算为血糖减去A1c衍生的平均葡萄糖,是SIH的一个关键指标.
- 以前的研究表明,关于SIH和CS患者的结果与糖尿病 (DM) 或没有糖尿病 (DM) 的结果不一致.
研究的目的:
- 为了研究血糖差距 (GG) 在心脏性休克 (CS) 患者的预后作用.
- 探索GG和CS患者30天死亡率之间的关联.
- 检查 CS 中 GG 和乳酸水平之间的相关性.
主要方法:
- 利用MIMIC-IV v2.0数据库的CS患者数据来评估GG和30天死亡率.
- 包括来自温州医科大学第二附属医院的CS患者来分析GG和乳酸相关性.
- 应用多变量分析,倾向性得分匹配 (PSM) 分析和反向概率治疗权重 (IPTW).
主要成果:
- 绝对和相对血糖差距 (GG) 都与CS患者30天全因死亡率的增加显著相关.
- 较高的GG水平与乳酸升高相关,表明严重程度增加.
- GG改善了格拉斯哥昏迷尺度 (GCS) 对死亡率的预测值,无论糖尿病状况如何.
结论:
- 血糖差距 (GG) 是对心脏性休克 (CS) 患者30天死亡率的有价值预测指标,独立于糖尿病 (DM).
- GG反映了CS的严重程度,与高乳糖血症和胰岛素抵抗有关.
- GG增强了像GCS这样的现有临床评分的预后能力.
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