压力高血糖比率作为早期死亡风险分层心血管疾病的生物标志物:倾向匹配分析
Mingxing Lei1,2,3,4, Yan Li5, Longcan Cheng6
1Department of Nursing, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China. leimingxing2@sina.com.
Cardiovascular diabetology
|July 12, 2025
概括
压力高血糖比率 (SHR) 与严重心血管疾病患者的早期死亡率有关. 虽然它有助于短期风险分层,但它对长期结果的预后价值会下降.
科学领域:
- 关键护理医学 关键护理医学
- 心血管医学 心血管医学
- 内分泌学 在内分泌学.
背景情况:
- 应激高血糖比率 (SHR) 在危急疾病中的预后意义已得到承认,但其对心血管疾病 (CVD) 患者死亡率的具体影响需要进一步阐明.
- 这项研究旨在调查重症心血管疾病患者的SHR和全因死亡率之间的关联,使用倾向得分匹配 (PSM) 来控制混变量.
研究的目的:
- 评估心血管疾病重症患者中不同水平的SHR和死亡结果之间的关系.
- 评估SHR对该患者群体短期和长期死亡率的预测值.
主要方法:
- 分析了3,352名危急心血管疾病患者的队列,按SHR四分位数分层.
- 倾向性得分匹配 (PSM) 创建了670对匹配对,以平衡高和低SHR组之间的共变量.
- 考克斯模型,受限立方线分析和卡普兰-梅尔曲线被用来评估不同时间点 (住院,28,90,365天) 的死亡风险.
主要成果:
- 较高的SHR四分位数与增加的并发症负担和严重程度得分有关.
- 在未经调整的分析中,增加的SHR与更高的住院和365天死亡率显著相关.
- 在PSM和调整后,高SHR仍然是早期死亡率 (住院和28天) 的重要预测因素,但不是长期死亡率.
- 包括SHR改善了短期死亡率预测,但在PSM后的长期预测方面显示出有限的益处.
结论:
- 升高的SHR是危急心血管疾病患者早期死亡的重要因素,独立于混因素.
- SHR证明了风险分层的实用性,特别是预测这一群体的短期结果.
- 对于长期死亡率来说,SHR的预后价值不那么明显,这表明它在急性护理决策中的首要作用.
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