中国全科医学2017，Vol.20Issue(5)：549-553,5.DOI:10.3969/j.issn.1007-9572.2017.05.009
血糖水平对肺栓塞患者预后的预测价值研究
Predictive Value of Blood Glucose Level on the Prognosis of Patients with Pulmonary Embolism
摘要
Abstract
Objective To explore the predictive value of blood glucose level at the admission on the prognosis of patients with pulmonary embolism. Methods The medical records of 376 patients who were firstly confirmed pulmonary embolism in the Affiliated Hospital of North China University of Science and Technology,Tangshan Gongren Hospital and Kailuan General Hospital,North China University of Science and Technology from 2011 to 2015 were retrospectively collected. According to the quartiles of blood glucose level,they were divided into four groups:group Ⅰ( n = 97),blood glucose less than 5. 10 mmol / L,group Ⅱ(n = 99),blood glucose between 5. 10 and 5. 88 mmol/ L,group Ⅲ(n = 97),blood glucose between 5. 89 and 7. 25 mmol/ L and group Ⅳ(n = 83),blood glucose greater than 7. 25 mmol/ L. After 30 - day follow - up for the enrolled patients,the primary outcome was all - cause mortality. Kaplan - Meier method was used to draw the survival curve and the Log- rank test and Cox proportional hazards regression model were adopted to analyze the predictive value of blood glucose level on the prognosis of patients with pulmonary embolism. Results A total of twenty pulmonary embolism patients died within 30 days after discharge and the all - cause mortality was 5. 32% . The mortality rate of patients with pulmonary embolism in group Ⅰwithin 30 days after discharge was 3. 09%(3 / 97),group Ⅱ was 1. 01%(1 / 99),group Ⅲ was 3. 09% (3 / 97),and groupⅣ was 15. 66% (13 / 83). After the adjustment of gender,age,BMI,smoking,drinking,hospitalization days,pulse, breathing rate,systolic blood pressure,changes in mental status,underlying disease at the admission,the Cox proportional hazards regression model analysis concluded that the death risk of patients with pulmonary embolism within 30 days after discharge increased when the blood glucose was greater than 7. 25 mmol/ L〔HR = 7. 31,95% CI(1. 16,46. 15),P < 0. 05〕. The Log- rank test showed that the mortality rate of the four groups of patients with pulmonary embolism within 30 days after discharge was significantly different(χ2 = 23. 490,P < 0. 01),and the mortality rate in group Ⅳ within 30 days after discharge was higher than that in group Ⅰ,Ⅱ and Ⅲ(P < 0. 007). Conclusion The elevated blood glucose level at the admission is associated with increased death risk of patients with pulmonary embolism within 30 days after discharge,and it can effectively predict the prognosis of patients with pulmonary embolism. The clinicians should help to control the blood glucose level of patients with pulmonary embolism,and improve their survival rate.关键词
肺栓塞/预后/血糖Key words
Pulmonary embolism/Prognosis/Blood glucose分类
医药卫生引用本文复制引用
郭春月,范红敏,胡泊,尹素凤,刘晓宇,张琦,许春杰,张晓雅,薛玲,冯福民..血糖水平对肺栓塞患者预后的预测价值研究[J].中国全科医学,2017,20(5):549-553,5.基金项目
河北省自然科学基金资助项目（H2016209042）；华北理工大学培育基金项目 （）
