应激性血糖升高比值对老年心力衰竭病人急救效果的影响

doi:10.3969/j.issn.1003-9198.2022.12.009

摘要/Abstract

摘要： 目的分析应激性血糖升高比值(SHR)对老年心力衰竭病人急救效果的影响。方法采用回顾性分析研究法,纳入2018年1月至2021年1月期间南京医科大学附属南京医院收治的106例老年心力衰竭病人,依据病人的急救效果将其分为不良组(n=68)和良好组(n=38)。分析不良组老年心力衰竭病人的终点事件,对2组的一般资料和临床资料进行比较。采用Logistic回归分析老年心力衰竭病人急救不良的危险因素,并分析SHR对老年心力衰竭病人急救不良的预测价值。结果 106例病人中共68例发生不良终点事件,其中48例为主要不良心血管事件(MACE),以全因死亡为主,其余20例为次要终点,以再发心绞痛为主。多因素Logistic回归分析显示,年龄≥70岁、LVEF＜40％、心源性休克、SHR≥1.05、氨基末端脑钠肽前体(NT-proBNP)≥5000 μg/L、WBC≥7×10⁹/L为老年心力衰竭病人急救不良的危险因素(P＜0.05)。SHR对老年心力衰竭病人急救不良预测的灵敏度和特异度分别为73.5%、73.7%,具有较佳的预测价值。结论 SHR≥1.05为老年心力衰竭病人急救不良的危险因素,对老年心力衰竭病人急救不良有较佳的预测价值。

关键词: 心力衰竭, 老年人, 应激性血糖升高比值, 急救, 预测

Abstract: Objective To analyze the effect of stress hyperglycemia ratio (SHR) on the emergency outcome of elderly patients with heart failure. Methods A retrospective analysis was carried out on the clinical data of 106 elderly patients with heart failure admitted to our hospital from January 2018 to January 2021. The patients were divided into poor outcome group (n=68) and good outcome group (n=38) according to the emergency outcome. The endpoint events of the elderly patients with heart failure in poor outcome group were analyzed. The clinical data of the two groups were analyzed, and Logistic regression analysis was used to identify the risk factors for poor emergency outcome in the elderly patients with heart failure. The predictive value of SHR for poor emergency treatment in the elderly patients with heart failure was analyzed. Results A total of 68 out of 106 patients had adverse endpoint events, and 48 cases were major adverse cardiovascular events (MACE), with all-cause deaths (19.81%) as the main cause; the other 20 cases were the secondary endpoint events, with recurrence of angina pectoris (11.32%) as the main cause. Multivariate Logistic analysis showed that age ≥ 60 years, LVEF <40%, cardiogenic shock, SHR ≥ 1.05, NT-proBNP ≥ 5000 μg/L, WBC ≥ 7×10⁹/L were the risk factors of poor emergency outcome in the elderly patients with heart failure (P<0.05). SHR has a sensitivity of 73.5% and a specificity of 73.7% in predicting poor emergency outcome in the elderly patients with heart failure. Conclusions SHR≥1.05 is a risk factor for poor emergency outcome in the elderly patients with heart failure, which has a better predictive value for poor emergency outcome.

Key words: heart failure, aged, stress hyperglycemia ratio, emergency, prediction

中图分类号:

R541.6

肖峰, 秦海东, 孙才智, 刘晓东. 应激性血糖升高比值对老年心力衰竭病人急救效果的影响[J]. 实用老年医学, 2022, 36(12): 1220-1224.

XIAO Feng, QIN Hai-dong, SUN Cai-zhi, LIU Xiao-dong. Influence of the ratio of stress-induced blood glucose elevation on the emergency outcome of elderly patients with heart failure[J]. Practical Geriatrics, 2022, 36(12): 1220-1224.

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