术后血糖变化作为冠状动脉旁路移植后一年死亡率的预测因素:一项回顾性队列研究
Jiasen Ma1, Junjun Qin1, Fengkai Mao2
1Department of Anesthesiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China.
BMC cardiovascular disorders
|November 27, 2025
概括
术后高血糖变异性 (GV) 增加了冠状动脉旁路移植 (CABG) 后的一年死亡风险. 这种风险在没有糖尿病的患者中尤为明显,这凸显了针对性干预的必要性.
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:
- 手术后血糖变化 (GV) 与不良结果有关.
- 在心脏手术后,GV对长期死亡率的具体影响尚不清楚.
- 调查GV在冠状动脉旁路移植 (CABG) 后一年死亡率中的作用至关重要.
研究的目的:
- 为了确定术后GV是否与CABG后的一年死亡率有关.
- 评估手术前血红蛋白A1c (HbA1c) 和糖尿病状态对与GV相关的死亡风险的影响.
主要方法:
- 从MIMIC-IV数据库 (2008-2019) 中对3,598名接受CABG的患者进行了回顾性分析.
- 根据手术后的GV水平 (低或高) 划分患者.
- 考克斯的比例危险模型和卡普兰-梅尔曲线分析了GV和一年死亡率之间的关联.
主要成果:
- 在CABG后的一年死亡率为4.92%.
- 术后GV增加与更高的一年死亡率显著相关 (HR=1.146在完全调整的模型中).
- 在没有糖尿病 (DM) 的患者和HbA1c ≤ 7.0%的患者中,这种关联更为强烈.
结论:
- 术后GV升高是CABG后1年死亡率增加的重要预测因素.
- 这些发现表明需要针对性策略来管理GV,特别是在非糖尿病患者中.
- 这项研究为减少心脏手术后的死亡率提供了指导.
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