应激性高血糖比值对急性心肌梗死患者院内不良预后的影响  

Effect of stress hyperglycemic ratio on poor in-hospital prognosis in patients with acute myocardial infarction

作　　者：董征[1] 杨青苗[1] 郭彩霞 Dong Zheng;Yang Qingmiao;Guo Caixia(Department of Cardiovascular Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院心血管中心,北京100176

出　　处：《首都医科大学学报》2024年第3期494-500,共7页Journal of Capital Medical University

基　　金：首都医科大学附属北京同仁医院青年杰出人才基金项目(2021-YJJ-ZZL-001)。

摘　　要：目的探讨应激性高血糖比值(stress hyperglycemia ratio,SHR)对急性心肌梗死(acute myocardial infarction,AMI)患者院内主要不良心血管事件(major adverse cardiovascular events,MACEs)的预测价值。方法回顾性分析2022年1月至2022年12月在首都医科大学附属北京同仁医院心血管中心住院,资料完整的AMI患者共442例。根据入院测得的第一个静脉随机血糖(admission blood glucose,ABG)和糖化血红蛋白(glycosylated hemoglobin,HbA1c)值计算得出SHR。根据是否发生院内MACEs分为MACEs组(n=79)和非MACEs组(n=363)。采用多因素Logistic回归分析探讨AMI患者院内MACEs发生的危险因素。应用受试者工作特征(receiver operating characteristic,ROC)曲线评估SHR对院内MACEs发生的预测价值。结果院内MACEs组的SHR显著高于非MACEs组(1.30±0.44 vs 1.15±0.17,P<0.001)。多因素Logistic回归分析中,SHR是AMI患者院内MACEs发生的危险因素(OR=2.69,95%CI:1.26~5.73,P=0.011)。ROC曲线分析结果显示,SHR对AMI患者院内MACEs有预测价值(AUC=0.63,95%CI:0.57~0.70,P<0.001),最佳截断值为1.29,预测价值高于HbA1c(P=0.011)。结论SHR是AMI患者院内MACEs发生的危险因素,对院内MACEs有预测价值,最佳截断值为1.29,优于HbA1c。Objective To explore the predictive value of stress hyperglycemia ratio(SHR)on in-hospital major adverse cardiovascular events(MACEs)in patients with acute myocardial infarction(AMI).Methods A total of 442 AMI patients with complete clinical data from January 2021 to December 2022 in the Department of Cardiology Center,Beijing Tongren Hospital were selected for retrospectively analyzed.SHR was calculated from the first blood glucose within 24 h after admission(ABG)and glycosylated hemoglobin(HbA1c)value.Patients were divided into MACEs group(n=79)and non-MACEs group(n=363)according to in-hospital MACEs.Logistic regression was used to analyze the risk factors for in-hospital MACEs.The receiver operating characteristic(ROC)curve was used to analyze SHR's predictive value.Results SHR in MACEs group was higher than that in non-MACEs group(1.30±0.44 vs 1.15±0.17,P<0.001).Multiple Logistic regression analysis indicated that elevated SHR level was an independent risk factor for in-hospital MACEs in AMI patients(OR=2.69,95%CI:1.26-5.73,P=0.011).ROC curve analysis showed that SHR(AUC=0.63,95%CI:0.57-0.70,P<0.001)had a certain predictive value for in-hospital MACEs in AMI patients,with the optimal cut-off value of 1.29,which is better than HbA1c(P=0.011).Conclusion SHR is a risk factor for in-hospital MACEs in AMI patients,and has predictive value for in-hospital MACEs,which is better than HbA1c.The optimal cut-off value is 1.29.

关 键 词：应激性高血糖比值 高血糖 急性心肌梗死 主要不良心血管事件 

分 类 号：R54[医药卫生—心血管疾病]