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投稿时间：2023-08-01 网络发布日期：2023-12-20
投稿时间：2023-08-01 网络发布日期：2023-12-20
中文摘要: 目的 探讨糖化血红蛋白指数（HGI）对急性失代偿性心力衰竭（ADHF）患者终点事件的预测价值。
方法 将2010年9月1日至2019年9月1日于南京大学医学院附属鼓楼医院心血管内科住院治疗的1 420例ADHF患者纳入本研究，并计算相应的HGI。根据HGI三分位数将患者分为三组：T1组（HGI≤0.499%，n=473），T2组（0.499%＜HGI≤1.108%，n=474），T3组（HGI＞1.108%，n=473）。终点事件包括全因死亡、心血管死亡及主要不良心脑血管事件（MACCE）。通过Kaplan-Meier曲线评估三组患者终点事件的发生率，采用多因素COX风险比例模型探讨HGI与终点事件的关系。
结果 在60个月的随访时间内，研究队列的全因死亡、心血管死亡和MACCE的发生率分别为25.28%、13.03%、58.59%。校正的Kaplan-Meier曲线显示全因死亡率和心血管死亡率随HGI增高而降低（P＜0.05），MACCE差异无统计学意义（P＞0.05）。在校正的多变量COX风险比例模型中， HGI升高与全因死亡发生率（HR=0.501，95%CI：0.336~0.747，P=0.001）和心血管死亡发生率（HR=0.438，95%CI：0.255~0.754，P=0.003）下降显著相关。结论 HGI升高与ADHF患者全因死亡率和心血管死亡率下降相关，与MACCE的发生无关。
中文关键词: 糖化血红蛋白指数 急性失代偿性心力衰竭 全因死亡 心血管死亡 主要不良心脑血管事件
Abstract:Objective To investigate the predictive value of hemoglobin glycation index (HGI) for endpoint events in patients with acute decompensated heart failure (ADHF).
Methods A total of 1 420 patients with ADHF who were admitted to the Department of Cardiology, Nanjing Drum Tower Hospital from September 1, 2010, to September 1, 2019, were included in this study, and the corresponding HGI values were calculated. The patients were divided into three groups based on the tertiles of HGI ［group T1（HGI≤0.499%， n=473），group T2（0.499%＜HGI≤1.108%， n=474），group T3（HGI＞1.108%， n=473）］. The endpoints included all-cause mortality, cardiovascular mortality, and major adverse cardiovascular and cerebrovascular events (MACCE). The occurrence rates of the endpoints in the three groups were evaluated by Kaplan-Meier curves, and the predictive value of HGI for the endpoints was assessed by the multivariable COX proportional hazards model.
Results During a follow-up period of 60 months, all-cause mortality was 25.28%, cardiovascular mortality was 13.03%, and MACCE incidence rate was 58.59% in the study cohort. The adjusted Kaplan-Meier curves showed that all-cause mortality and cardiovascular mortality decreased with increasing HGI values (P＜0.05). There was no significant difference in incidence rate of MACCE among three groups (P>0.05). In the adjusted multivariate COX proportional hazaras model, the increase in HGI was significantly associated with a decrease in all-cause mortality (HR=0.501, 95%CI: 0.336-0.747, P=0.001) and cardiovascular mortality (HR=0.438, 95%CI: 0.255-0.754, P=0.003). Conclusion Increased HGI values are significantly associated with decreased all-cause mortality and cardiovascular mortality in patients with ADHF, but not with the occurrence of MACCE.
keywords: Hemoglobin glycation index Acute decompensated heart failure All-cause death Cardiovascular death Major adverse cardiac and cerebrovascular events
文章编号： 中图分类号：R541.6 文献标志码：A
基金项目:江苏省社会发展面上项目（BE2022665）；南京市医学科技发展基金项目(YKK19063)
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引用文本：
浦越,成维梦,李天玥,等.糖化血红蛋白指数对急性失代偿性心力衰竭患者临床结局的预测价值[J].中国临床研究,2023,36(12):1786-1792.
浦越,成维梦,李天玥,等.糖化血红蛋白指数对急性失代偿性心力衰竭患者临床结局的预测价值[J].中国临床研究,2023,36(12):1786-1792.