应激性高血糖比率与重症慢性阻塞性肺病30天死亡率的相关性:一项来自MIMIC-Ⅳ数据库的回顾性队列研究  

Association between Stress Hyperglycemia Ratio and 30-day Mortality in Critically Ill Patients with COPD:A Retrospective Cohort Study from the MIMIC-IV Database

作　　者：蔡雷琴 李娜[1] 王成芷 劳国娟[1] 孙侃[1] 黄楚霖[1] CAI Lei-qin;LI Na;WANG Cheng-zhi;LAO Guo-juan;SUN kan;HUANG Chu-lin(Department of endocrinology,Sun Yat-Sen Memorial Hospital,Sun Yat-sen University,Guangdong Province,Guangzhou,510120)

机构地区：[1]中山大学孙逸仙纪念医院内分泌科,510120

出　　处：《岭南急诊医学杂志》2024年第6期638-640,657,共4页Lingnan Journal of Emergency Medicine

基　　金：中山大学临床医学研究5010计划项目培育项目(2018021)。

摘　　要：目的:探讨应激性高血糖比率(stress hyperglycemia ratio,SHR)与重症慢性阻塞性肺病(COPD)患者30天死亡率的相关性。方法:本研究基于重症监护医疗信息市场IV(Medical Information Mart for Intensive Care-Ⅳ,MIMIC-IV)数据库,纳入诊断为COPD的患者。主要结局事件为30天死亡率。根据SHR的四分位数将患者分组,采用生存分析与Cox回归分析评估SHR与30天死亡率的关联,并通过限制性立方样条分析确定其非线性关系。结果:SHR最高四分位组的30天死亡率显著高于其他组。经混杂因素校正后,与最低四分位组相比,最高四分位组的死亡风险显著增加。限制性立方样条图分析表明,SHR与30天死亡率之间存在“J”型非线性关系。结论:SHR升高与重症COPD患者30天死亡率的增加独立相关,SHR与重症COPD患者30天死亡率呈“J”型非线性关系。Objective:To investigate the correlation between stress hyperglycemia ratio(SHR)and 30-day mortality in patients with severe chronic obstructive pulmonary disease(COPD).Methods:This study was based on the Medical Information Mart for Intensive Care-IV(MIMIC-IV)database and included patients diagnosed with COPD.The primary outcome event was 30-day mortality.Patients were grouped according to the quartile of SHR,survival analysis and Cox regression analysis were used to assess the association between SHR and 30-day mortality,and the nonlinear relationship was determined by restricted cubic spline analysis.Results:The 30-day mortality was significantly higher in the highest quartile SHR group than in the other groups.After adjusting for confounders,the highest quartile group had a significantly increased risk of death compared to the lowest quartile group.Restricted cubic spline analysis showed that there was a“J”type nonlinear relationship between SHR and 30-day mortality.Conclusion:Increased SHR was independently associated with increased 30-day mortality in patients with severe COPD,and there was a“J”type nonlinear relationship between SHR and 30-day mortality in patients with severe COPD.

关 键 词：应激性高血糖比率 MIMIC数据库 慢性阻塞性肺病 非限制性立方样条图 

分 类 号：R563.9[医药卫生—呼吸系统]