| 沈敏伟,徐建鸣,赵赟,林佳.血糖指标与老年心脏外科手术患者预后的相关性研究[J].上海护理,2021,21(11): |
| 血糖指标与老年心脏外科手术患者预后的相关性研究 |
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| DOI： |
| 中文关键词: 心外科手术 血糖 糖化血红蛋白 ROC曲线 |
| 英文关键词:surgery,glycosylation curve, ROC |
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| 中文摘要: |
| 目的：探讨血糖指标对老年心外科手术患者心功能指标的相关性以及对预后效果的影响。方法：以复旦大学附属中山医院 2018 年 4 月—6 月心外科手术的135例老年患者为研究对象,针对冠心病患者实施冠脉搭桥术,瓣膜病患者实施体外循环下瓣膜置换术,同时进行术前血糖监测与术中血糖控制。根据患者预后情况进行分组对比,评价其美国纽约心脏病学会(NYHA)分级、血管狭窄数目、糖化血红蛋白、射血分数差异,并行相关性和ROC曲线绘制。结果：135例患者,预后不良10例(7.41%)。预后不良组与良好组比较,NYHY分级、血管狭窄数目(<3条)、糖化血红蛋白、射血分数测定结果均有显著差异(P<0.05)。相关性分析,预后不良患者心功能指标NYHA分级与糖化血红蛋白水平之间呈现为非常显著的正相关性(r=0.210,P<0.05),血管狭窄数目(<3条)、射血分数与糖化血红蛋白水平之间呈现为非常显著的负相关性(r=-0.440,r=-0.210,P<0.05)。ROC曲线分析,糖化血红蛋白水平在对心外科手术的影响评价中,AUC计算结果为0.821,灵敏度为73.8%,特异度为83.9%,临界值为7.15%。结论：老年心外科手术预后不良患者均表现出高糖化血红蛋白水平,且与各项心功能指标均表现出相关性,可证实其对老年心外科手术患者有着直接或者间接的影响。 |
| 英文摘要: |
| Objective: To investigate the correlation between blood glucose and cardiac function in elderly patients undergoing cardiac surgery and its influence on prognosis. Methods: 135 elderly patients in April 2018 to June surgical heart Zhongshan Hospital for the study. Coronary artery bypass grafting was performed in patients with coronary heart disease, and valve replacement under extracorporeal circulation was performed in patients with valvular disease. According to the prognosis of the patients, the differences of NYHA classification, vascular stenosis number, glycosylated hemoglobin, ejection fraction, parallel correlation and ROC curve were evaluated. Results: among 95 patients, 10 (7.41%) had poor prognosis. There were significant differences in nyhy classification, number of stenosis (< 3), glycosylated hemoglobin (HbA1c) and ejection fraction (EF) between the poor prognosis group and the good group (P<0.05). Correlation analysis showed that there was a very significant positive correlation between NYHA grade and glycosylated hemoglobin level in patients with poor prognosis (r = 0.210, P<0.05), and there was a very significant negative correlation between the number of vascular stenosis (<3), ejection fraction and glycosylated hemoglobin level (r=-0.440, r=-0.210, P<0.05). ROC curve analysis showed that in the evaluation of the effect of glycosylated hemoglobin level on cardiac surgery, the AUC calculation result was 0.821, the sensitivity was 73.8%, the specificity was 83.9%, and the critical value was 7.15%. Conclusion: the level of HbA1c in elderly patients with poor prognosis after cardiac surgery is correlated with various cardiac function indexes, which can prove that it has a direct or indirect impact on elderly cardiac surgery patients. |
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