应激性高血糖比值与伴2型糖尿病的急性心肌梗死患者急诊PCI术后预后的关系

The relation between stress hyperglycemia ratio and prognosis of AMI patients with T2DM after primary PCI

目的探讨应激性高血糖比值与急性心肌梗死(AMI)合并2型糖尿病(T2DM)经皮冠状动脉(下称冠脉)介入治疗(PCI)术后患者预后的关系。方法回顾性选择2019年1月至2021年12月在舟山市普陀人民医院接受PCI的AMI合并T2DM患者112例。测定入院即刻血糖和糖化血红蛋白(HbA1C)并计算应激性高血糖比值。根据随访2年的预后将患者分为存活组和死亡组,比较两组的应激性高血糖比值,采用多因素logistic回归分析应激性高血糖比值与不良预后的关系。结果死亡组患者入院血糖、HbA1C水平高于存活组,差异均有统计学意义(均P<0.05)。死亡组患者应激性高血糖比值为(1.47±0.38),高于存活组(1.04±0.15),差异有统计学意义(P<0.05)。应激性高血糖比值是影响AMI合并T2DM经PCI术后患者预后不良的独立危险因素(P<0.05)。高比值患者2年内存活率为77.78%(21/27),低于低比值患者的91.76%(78/85),差异有统计学意义(χ^(2)=7.577,P=0.006)。结论应激性高血糖比值与AMI合并T2DM患者经PCI术后预后相关。

Objective To investigate the association of stress hyperglycemia ratio(SHR)with the prognosis of patients with acute myocardial infarction(AMI)and type 2 diabetes mellitus(T2DM)after primary percutaneous coronary intervention(PCI).Methods A retrospective analysis was conducted on 112 AMI patients with T2DM who underwent PCI in Putuo People's Hospital from January 2019 to December 2021.Admission glucose and glycosylated hemoglobin(HbA1C)were measured and SHR was calculated.They were divided into survival group and death group based on the outcomes during two years follow-up.SHR was compared between the two groups.Multivariate logistic regression analysis was used to determine the relation between SHR and adverse prognosis.Results Admission glucose and HbA1C were significantly higher in the death group than in the survival group(both P<0.05).SHR was(1.47±0.38)in the death group,significantly higher than(1.04±0.15)in the survival group(P<0.05).SHR was an independent risk factor for adverse prognosis in patient with AMI and T2DM after primary PCI(P<0.05).The survival rate was significantly lower in patients with high SHR(77.78%,21/27)than in patients with low SHR(91.76%,78/85)(χ^(2)=7.577,P=0.006).Conclusion SHR is related to the prognosis of AMI patients with T2DM after PCI.