严重肺栓塞患者的血糖变化和死亡率之间的反转U形关系:一项回顾性研究
Huihui Tan1, Zihao Tang2, Renyi Wu3
1Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University.
Journal of atherosclerosis and thrombosis
|March 8, 2026
概括
高血糖和血糖变化独立预测肺栓塞患者的死亡率. 最佳的血糖控制可能会改善PE重症患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
背景情况:
- 过高血糖和血糖变化 (GV) 是已知的预测者,危急病患者的不良结果.
- 平均血糖 (MBG) 和GV在肺栓塞 (PE) 结局中的具体作用尚未得到充分确定.
研究的目的:
- 调查诊断为PE的危急病患者的MBG,GV和死亡率之间的关联.
主要方法:
- 使用MIMIC-IV 3.0数据库对1493名PE患者进行了回顾性队列研究.
- 用变化系数 (CV) 量化的GV;用MBG和CV三位数分层的患者.
- 多变量后勤回归,受限立方线 (RCS) 和ROC曲线分析了与ICU和住院死亡率的关联.
主要成果:
- 较高的MBG和CV显著与急症监护室和住院死亡率的增加有关.
- RCS显示了MBG的线性关联,以及CV与死亡率的反转U形关系.
- 组合模型 (MBG + CV + ERS) 在死亡率预测方面实现了0.735 (ICU) 和0.693 (住院) 的AUC.
结论:
- MBG和CV是重症PE患者死亡率的独立预测因素.
- 研究结果表明,优化血糖控制可能对这种患者群体有益.
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