首页|既往使用他汀类药物对合并2型糖尿病的脓毒症成年患者病死率的影响

既往使用他汀类药物对合并2型糖尿病的脓毒症成年患者病死率的影响

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目的 评估入院前使用他汀类药物对合并2型糖尿病(T2DM)的脓毒症成年患者住院病死率的影响。方法 从重症监护医学信息市场(MIMIC Ⅳ)数据库中回顾性收集合并T2DM的脓毒症患者3 545例,以院内病死率为结局变量。根据既往是否服用过他汀类药物分为两组,使用倾向性评分匹配,多变量Cox回归分析方法计算校正风险比(HR)及95%CI,分析既往使用他汀类药物与合并T2DM的脓毒症患者住院病死率的关系。结果 共纳入2008年—2016年间3 545例合并T2DM的脓毒症患者,1 556例入院前使用他汀类药物,1 989例患者未使用他汀类药物,倾向性评分匹配后,既往使用他汀类药物和未使用他汀类药物分别为1 230例和1 298例。校正潜在混杂因素后发现,既往使用他汀类药物与住院病死率降低相关(HR=0。82,95%CI:0。61~0。99,P=0。038)。Kaplan-Meier曲线显示,入院前使用他汀类药物的脓毒症合并T2DM患者住院病死率较低(Log-rank检验:P<0。001)。结论 入院前使用他汀类药物可能与合并T2DM的脓毒症患者病死率降低相关。
Effect of prior statins use on the mortality rate among adult sepsis patients with type 2 diabetes
Objective To evaluate the effect of prior statins use on the in-hospital mortality of adult sepsis patients with type 2 diabetes(T2DM).Methods A total of 3 545 sepsis patients with T2DM were retrospectively collected from the Critical Care Medical Information Market(MIMIC Ⅳ)database,with in-hospital mortality rate as the outcome variable.According to whether they have taken statins in the past,they were divided into two groups and propensity score matching was used.Multivariate Cox regression analysis was performed to calculate the adjusted hazard ratio(HR)and 95%CI,and the relationship between past statins use and in-hospital mortality in sepsis patients with T2DM was analyzed.Results A total of 3 545 sepsis patients with T2DM were included between 2008 and 2016.1 556 patients used statins before admission,and 1 989 patients did not use statins.After propensity score matching,the number of patients who had previously used statins and those who had not used statins were 1 230 and 1 298,respectively.After adjusting for potential confounding factors,it was found that previous use of statins was associated with a reduced in-hospital mortality rate(HR=0.82,95%CI:0.61-0.99,P=0.038).Kaplan Meier curves showed that sepsis patients with T2DM who used statins before admission had a lower in-hospital mortality rate(Log rank test:P<0.001).Conclusions Pre admission use of statins may be associated with a reduced mortality rate in sepsis patients with concomitant T2DM.

Diabetes mellitus,type 2SepsisStatinsMortality

张秋华、张志明、杜建业、林彤、焦唱、李建民、周静

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唐山南湖医院心内二科,唐山 063000

华北理工大学附属医院神经外科,唐山 063000

糖尿病,2型 脓毒症 他汀类药物 病死率

河北省卫健委医学研究项目唐山市科技计划项目

2022153321130224C

2024

中国医师杂志
中华医学会 湖南省医学会

中国医师杂志

CSTPCD
影响因子:0.876
ISSN:1008-1372
年,卷(期):2024.26(9)