平均空腹血糖对老年慢性心力衰竭患者预后的影响

目的 评估平均空腹血糖对老年慢性心力衰竭患者住院预后的影响.方法 对284例发病72h内入院的无糖尿病史的慢性心力衰竭患者进行回顾性分析,依据入院后72h内平均空腹血糖水平分为＜7.0 mmol/L,≥7.0 mmol/L2组,分析其临床特征、住院治疗经过和主要心脏事件及死亡的发生率,分析评估平均空腹血糖对住院死亡的预测价值.结果 随着血糖升高,左心室射血分数降低,心力衰竭、恶性心律失常及住院病死率明显增加(P＜0.05),显示入院72h内平均空腹血糖是住院病死率的独立危险因素.结论 入院72h内平均空腹血糖是老年慢性心力衰竭患者住院死亡的独立危险因素.

Impact of first 72 hours mean blood glucose level on the prognosis of hospitalized elderly patients with chronic heart failure

Objective To evaluate the impact of mean fasting glucose over the 72 hours during hospitalization in the elderly patients with chronic heart failure(CHF). Methods The date of 284 non-diabetic patients hospitalized with CHF were included. The mean blood glucose (MBG) level through the first 72 hours for each patient was calculated, patients were stratified into 2 groups according to their MBG levels: <7.0 mmol/L(n=150) and ≥7.0 mmol/L(n=134) , Clinical characteristics, therapeutic approaches and the incidence of heart failure, malignant arrhythmias, and death during hospitalization were compared among groups. Results Higher mean fasting glucose levels were associated with increased risk of reduced left ventricular ejection fraction, heart failure characterized by higher Killip class, and malignant arrhythmias(P<0.05). Conclusion Mean fasting glucose during first 72 hours after admission is an independent predictor for in-hospital death and complications in the elderly patients with CHF.