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目的:探讨高入院血糖对经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)患者早期和晚期死亡风险的预后作用。方法:通过检索PubMed、EMBASE、Web of Science、the Cochrane Library和中国生物医学文献数据库(CBM)获取相关文献,使用固定效应模型或随机效应模型合并各研究的死亡相对危险度(RR)及其可信区间(CI)。结果:7篇文献报告了早期或晚期死亡率。Meta结果显示,高入院血糖组的早期死亡风险是低入院血糖组的2.00倍(95%CI:1.40~2.86)。高入院血糖组的晚期死亡风险(基于早期生存者)仍然稍高于低入院血糖组(RR=1.24,95%CI:0.63~2.43),但并没有统计学意义。结论:在PCI时代,既往糖尿病史合并高入院血糖的STEMI患者,其早期死亡风险显著高于入院血糖非增高组,入院血糖可以作为短期预后的评价因素;但其基于早期生存者的晚期死亡风险与低血糖组并无显著性差异,其预后意义需谨慎对待。
Objective: To investigate the prognostic role of high blood glucose in patients with early stage and advanced stage of acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). METHODS: Relevant articles were retrieved by searching PubMed, EMBASE, Web of Science, the Cochrane Library and CBM, and the relative risk of death (RR) and their association with each other were calculated using the fixed-effects model or the random-effects model Letter interval (CI). Results: Seven articles reported either early or late mortality. Meta results showed that the risk of early death in the high glucose group was 2.00 times lower than that in the low blood glucose group (95% CI: 1.40-2.86). The late death risk (based on early survival) in the high glucose group was still slightly higher than in the lower blood glucose group (RR = 1.24, 95% CI: 0.63 to 2.43), but not statistically significant. CONCLUSIONS: In the PCI era, the risk of early death was significantly higher in STEMI patients with previous history of diabetes mellitus than in those with non-hyperglycemia, and admission glucose could be used as an assessment of short-term prognosis; however, the risk of late death based on early survival There was no significant difference with hypoglycemia group, and its prognostic significance should be treated with caution.