Int J Cardiol:急性心肌梗死患者血钾和血糖水平与院内死亡率的相关性

2019-02-18 xing.T 网络

由此可见,该研究发现低K和高葡萄糖水平的个体具有最高的独立死亡风险。有必要进行额外的研究来评估在这种情况下K/葡萄糖水平的机制和治疗干预。

急性心肌梗死(AMI)与显著的全身代谢变化有关。这些变化包括反向调节激素的血浆浓度增加以及钾(K,mEq/L)和葡萄糖(mg/dL)水平的变化。后者与患者结局相关,并作为潜在的干预重点而被研究。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,该研究旨在评估伴随的K和葡萄糖(K/葡萄糖)水平与AMI患者院内死亡率之间的关系。

研究人员分析了2002-2012年期间在三级医疗中心住院的AMI患者。将K/葡萄糖水平分成相同大小的组别。中间组(葡萄糖124-143mg/dL,K4-4.9mEq/L)作为参考组。使用广义估计方程模型评估这些检查结果与患者结局的关联,该模型包括K和葡萄糖水平的相互作用,根据患者的基线特征和其他实验室结果进行调整。

该研究纳入了17670名AMI患者(平均年龄为67.8±4.0岁,66.6%为男性,死亡率为7.7%); 共记录了112531个K/葡萄糖检查结果。单变量和多变量分析显示K/葡萄糖水平与院内死亡率显著相关,伴随低K(<3.7mEq/L)和高葡萄糖(≥217mg/dL)的患者风险最高,调整后OR=2.53 。似乎低正常葡萄糖水平减弱了与低K相关的风险。

由此可见,该研究发现低K和高葡萄糖水平的个体具有最高的独立死亡风险。有必要进行额外的研究来评估在这种情况下K/葡萄糖水平的机制和治疗干预。

原始出处:

YgalPlakht,et al.The association of concomitant serum potassium and glucose levels and in-hospital mortality in patients with acute myocardial infarction. Soroka acute myocardial infarction II (SAMI-II) project.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.02.031

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