应激性高血糖对急性心力衰竭患者危险分层及预后的影响  

Influence of stress hyperglycemia on risk stratification and prognosis in patients with acute heart failure

作　　者：肖丽[1] 夏振伟[1] 郑剑朦 王贺妍 Xiao Li;Xia Zhenwei;Zheng Jianmeng;Wang Heyan(Second Department of Arrhythmia,Central Hospital of Dalian City,Dalian116033,China)

机构地区：[1]大连市中心医院心律失常二科,大连116033 [2]大连市中心医院心力衰竭科,大连116033

出　　处：《中国循证心血管医学杂志》2023年第4期495-497,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的 探讨应激性高血糖对急性心力衰竭患者危险分层及预后的影响。方法 回顾性分析2021年6月至2022年6月于大连市中心医院收治的100例急性心力衰竭患者的临床资料,根据患者入院时空腹血糖(FBG)水平分为观察组(n=32)和对照组(n=68)。比较两组患者基础资料、心脏治疗有效性的强化反馈(EFFECT)评分及1年不良心血管事件发生率,并分析患者发生应激性高血糖的危险因素。结果 观察组收缩压(SBP)、N末端脑钠肽前体(NT-proBNP)、空腹血糖(FBG)及美国纽约心脏病协会(NYHA)分级Ⅲ~Ⅳ级均高于对照组,左室射血分数(LVEF)低于对照组,差异有统计学意义(P<0.05);观察组30 d、1年的EFFECT评分分别为(73.40±9.89)分、(86.52±13.46)分,明显高于对照组的(64.02±12.73)分、(75.64±12.04)分,差异有统计学意义(P<0.05);观察组1年不良心血管事件总发生率为31.25%,明显高于对照组的8.82%,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,SBP、LVEF、NT-proBNP、NYHA分级均是导致急性心力衰竭患者发生应激性高血糖的危险因素(P<0.05)。结论 应激性高血糖对急性心力衰竭患者预后影响较大,可对早期危险分层进行预警,且发病危险因素较多,应予以密切关注。Objective To discuss the influence of stress hyperglycemia on risk stratification and prognosis in patients with acute heart failure(AHF).Methods The clinical materials of AHF patients(n=100)were retrospectively analyzed in Central Hospital of Dalian City from June 2021 to June 2022.All patients were divided,according to level of fasting blood glucose(FBG)at admission time,into observation group(n=32)and control group(n=68).The basic data,scores of enhanced feedback for effective cardiac treatment(EFFECT)and 1-y incidence of adverse cardiovascular events were compared,and risk factors of stress hyperglycemia were analyzed in 2 groups.Results The levels of systolic blood pressure(SBP),NT-proBNP and FBG,and NYHA classification of heart function(grades from II to IV)were higher,and level of left ventricular ejection fraction(LVEF)were lower in observation group than those in control group(P<0.05).The 30-d and 1-y scores of EFFECT was,respectively,(73.40±9.89)and(86.52±13.46)in observation group,and(64.02±12.73)and(75.64±12.04)in control group(P<0.05).The 1-y incidence of adverse cardiovascular events was 31.25%in observation group and 8.82%in control group(P<0.05).The results of multi-factor Logistic regression analysis showed that SBP,LVEF,NT-proBNP and NYHA classification of heart function all were risk factors of stress hyperglycemia in AHF patients(P<0.05).Conclusions Stress hyperglycemia has a great impact on the prognosis in AHF patients.Early warning of risk stratification can be carried out,and there are many risk factors for the onset of AHF,which should be paid close attention to clinically.

关 键 词：急性心力衰竭 应激性高血糖 危险分层 预后 影响因素 

分 类 号：R541.61[医药卫生—心血管疾病]