非糖尿病患者A型主动脉夹层手术后血糖波动情况及相关影响因素分析

Analysis of blood glucose fluctuations and related influencing factors in non-diabetic patients with type A aortic dissection after surgery

目的探讨非糖尿病患者A型主动脉夹层手术后血糖波动的影响因素。方法选取2016年12月至2022年3月于宁波市医疗中心李惠利医院行手术治疗的109例非糖尿病A型主动脉夹层患者作为研究对象。应用Logistic回归分析探讨非糖尿病患者A型主动脉夹层手术后血糖波动的影响因素,构建非糖尿病患者A型主动脉夹层手术后血糖波动的列线图模型。结果Logistic回归分析结果显示,BMI≥24 kg/m2、睡眠质量较差、抑郁、体外循环时间>5 h及术中出血是非糖尿病A型主动脉夹层患者术后血糖波动的危险因素(P<0.05)。列线图模型的C-index是0.746(95%CI:0.711~0.781);校正曲线和理想曲线的一致性较好;列线图模型的AUC是0.804。结论BMI≥24 kg/m2、睡眠质量较差、抑郁、体外循环时间>5 h及术中出血是非糖尿病A型主动脉夹层患者术后血糖波动的危险因素。

Objective To investigate the influencing factors of blood glucose fluctuation after surgery for type A aortic dissection in non-diabetic patients.Methods A total of 109 patients with non-diabetic type A aortic dissection who underwent surgical treatment in Ningbo Medical Center Li Huili Hospital from Dec.2016 to Mar.2022 were selected as the research subjects.Logistic regression analysis was used to explore the influencing factors of blood glucose fluctuation in non-diabetic patients with type A aortic dissection surgery,and a nomogram model of blood glucose fluctuation in non-diabetic patients with type A aortic dissection surgery was constructed.Results Logistic regression analysis showed that BMI≥24 kg/m2,poor sleep quality,depression,cardiopulmonary bypass time>5 h and intraoperative bleeding were the risk factors for postoperative blood glucose fluctuation in non-diabetic type A aortic dissection patients(P<0.05).The C-index of the nomogram model was 0.746(95%CI:0.711-0.781);the calibration curve was in good agreement with the ideal curve;the AUC of the nomogram model was 0.804.Conclusion BMI≥24 kg/m2,poor sleep quality,depression,cardiopulmonary bypass time>5 h and intraoperative bleeding are risk factors for postoperative blood glucose fluctuation in non-diabetic type A aortic dissection patients.