应激性高血糖比值与急性心肌梗死患者预后关系的研究进展
Research Progress on the Relationship between Stress Hyperglycemia Ratio and Prognosis in Patients with Acute Myocardial Infarction
DOI: 10.12677/acm.2026.1651939, PDF,   
作者: 王馨溢, 陈紫君*：重庆医科大学附属永川医院心血管内科，重庆
关键词: 应激性高血糖比值；急性心肌梗死；预后；Stress Hyperglycemia Ratio； Acute Myocardial Infarction； Prognosis
摘要: 葡萄糖代谢异常是心血管疾病高发病率和高病死率的重要因素，更是急性心肌梗死(AMI)患者再发心肌梗死及全因死亡的重要危险因素。尽早评估影响患者预后的相关危险因素有助于指导治疗及改善预后。自2015年Roberts等学者首次提出应激性高血糖比值(SHR)的概念，越来越多的研究表明，SHR在危重患者的预后中有一定预测价值。现就SHR与AMI患者预后关系的临床研究进展进行综述，并探讨其潜在的病理生理机制。
Abstract: Abnormal glucose metabolism is an important contributor to the high morbidity and mortality of cardiovascular disease, it is also a significant risk factor for recurrent myocardial infarction and all-cause mortality in patients with acute myocardial infarction (AMI). Early assessment of the risk factors associated with the patient’s prognosis is helpful to guide treatment and improve outcomes. Since Roberts et al. first introduced the concept of the stress hyperglycemia ratio (SHR) in 2015, a growing body of research has demonstrated that SHR holds predictive value for the prognosis of critically ill patients. This review summarizes the recent advancements in clinical research concerning the relationship between SHR and the prognosis of patients with AMI, and explores its potential pathophysiological mechanisms.
文章引用：王馨溢, 陈紫君. 应激性高血糖比值与急性心肌梗死患者预后关系的研究进展[J]. 临床医学进展, 2026, 16(5): 1377-1384. https://doi.org/10.12677/acm.2026.1651939

参考文献

[1] Song, G., Liu, X., Lu, Z., Guan, J., Chen, X., Li, Y., et al. (2025) Relationship between Stress Hyperglycaemic Ratio (SHR) and Critical Illness: A Systematic Review. Cardiovascular Diabetology, 24, Article No. 188. [Google Scholar] [CrossRef] [PubMed]
[2] 陈小叶. 《急性ST段抬高型心肌梗死溶栓治疗的合理用药指南》第2版发布[J]. 中华医学信息导报, 2019, 34(1): 9.
[3] 张东, 李治璋, 马瑞楠, 等. 应激性高血糖比值与急性缺血性卒中患者临床预后的相关性研究[J]. 中国卒中杂志, 2022, 17(5): 483-490.
[4] Roberts, G.W., Quinn, S.J., Valentine, N., Alhawassi, T., O’Dea, H., Stranks, S.N., et al. (2015) Relative Hyperglycemia, a Marker of Critical Illness: Introducing the Stress Hyperglycemia Ratio. The Journal of Clinical Endocrinology & Metabolism, 100, 4490-4497. [Google Scholar] [CrossRef] [PubMed]
[5] Wang, M., Su, W., Cao, N., Chen, H. and Li, H. (2023) Prognostic Implication of Stress Hyperglycemia in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. Cardiovascular Diabetology, 22, Article No. 63. [Google Scholar] [CrossRef] [PubMed]
[6] Liao, W., Chen, Y., Gao, Q., Gan, R., Li, M., Liu, Z., et al. (2023) Impact of Stress Hyperglycemia Ratio, Derived from Glycated Albumin or Hemoglobin A1c, on Mortality among ST-Segment Elevation Myocardial Infarction Patients. Cardiovascular Diabetology, 22, Article No. 334. [Google Scholar] [CrossRef] [PubMed]
[7] 杨春霞. 血糖、糖化白蛋白、糖化血红蛋白在糖尿病诊断中的价值[J]. 医学信息, 2023, 36(13): 141-143.
[8] Zhang, P., Zhang, X., Zheng, K., He, L. and Lv, M. (2025) Association of the Stress Hyperglycemia Ratio (SHR) with 90-Day and 180-Day All-Cause Mortality in Patients Undergoing Coronary Artery Bypass Grafting (CABG) for Acute Myocardial Infarction (AMI): A Retrospective Cohort Study Using the MIMIC-IV Database. Medicine, 104, e45022. [Google Scholar] [CrossRef] 
[9] Okita, S., Saito, Y., Yaginuma, H., Asada, K., Goto, H., Hashimoto, O., et al. (2025) Impact of the Stress Hyperglycemia Ratio on Heart Failure and Atherosclerotic Cardiovascular Events after Acute Myocardial Infarction. Circulation Journal, 89, 340-346. [Google Scholar] [CrossRef] [PubMed]
[10] Schmitz, T., Freuer, D., Harmel, E., Heier, M., Peters, A., Linseisen, J., et al. (2022) Prognostic Value of Stress Hyperglycemia Ratio on Short-and Long-Term Mortality after Acute Myocardial Infarction. Acta Diabetologica, 59, 1019-1029. [Google Scholar] [CrossRef] [PubMed]
[11] Wang, N., Xu, Y., Feng, X., Zeng, M., Chen, X., Yu, B., et al. (2025) Stress Hyperglycemia Ratio and Long-Term Prognosis in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Evidence for an J-Shaped Association. Journal of Geriatric Cardiology, 22, 981-991. [Google Scholar] [CrossRef] 
[12] Xiong, S., Luo, Y., Chen, Q., Chen, Y., Su, H., Long, Y., et al. (2023) Adjustment of the GRACE Score by the Stress Hyperglycemia Ratio Improves the Prediction of Long-Term Major Adverse Cardiac Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Multicenter Retrospective Study. Diabetes Research and Clinical Practice, 198, Article ID: 110601. [Google Scholar] [CrossRef] [PubMed]
[13] Zeng, G., Song, Y., Zhang, Z., Xu, J., Liu, Z., Tang, X., et al. (2023) Stress Hyperglycemia Ratio and Long‐Term Prognosis in Patients with Acute Coronary Syndrome: A Multicenter, Nationwide Study. Journal of Diabetes, 15, 557-568. [Google Scholar] [CrossRef] [PubMed]
[14] Meng, W., Qiu, H., Li, W. and Li, H. (2025) Correlation between Stress Hyperglycemia Ratio and Prognosis in Acute Myocardial Infarction Patients Following Percutaneous Coronary Intervention. Frontiers in Cardiovascular Medicine, 12, Article 1493635. [Google Scholar] [CrossRef] [PubMed]
[15] Liu, J., Zhou, Y., Huang, H., Liu, R., Kang, Y., Zhu, T., et al. (2023) Impact of Stress Hyperglycemia Ratio on Mortality in Patients with Critical Acute Myocardial Infarction: Insight from American MIMIC-IV and the Chinese CIN-II Study. Cardiovascular Diabetology, 22, Article No. 281. [Google Scholar] [CrossRef] [PubMed]
[16] Karakasis, P., Stalikas, N., Patoulias, D., Pamporis, K., Karagiannidis, E., Sagris, M., et al. (2024) Prognostic Value of Stress Hyperglycemia Ratio in Patients with Acute Myocardial Infarction: A Systematic Review with Bayesian and Frequentist Meta-Analysis. Trends in Cardiovascular Medicine, 34, 453-465. [Google Scholar] [CrossRef] [PubMed]
[17] Abdu, F.A., Galip, J., Qi, P., Zhang, W., Mohammed, A., Liu, L., et al. (2023) Association of Stress Hyperglycemia Ratio and Poor Long-Term Prognosis in Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries. Cardiovascular Diabetology, 22, Article No. 11. [Google Scholar] [CrossRef] [PubMed]
[18] Gao, S., Huang, S., Lin, X., Xu, L. and Yu, M. (2023) Prognostic Implications of Stress Hyperglycemia Ratio in Patients with Myocardial Infarction with Nonobstructive Coronary Arteries. Annals of Medicine, 55, 990-999. [Google Scholar] [CrossRef] [PubMed]
[19] Cui, K., Fu, R., Yang, J., Xu, H., Yin, D., Song, W., et al. (2023) The Impact of Fasting Stress Hyperglycemia Ratio, Fasting Plasma Glucose and Hemoglobin A1c on In-Hospital Mortality in Patients with and without Diabetes: Findings from the China Acute Myocardial Infarction Registry. Cardiovascular Diabetology, 22, Article No. 165. [Google Scholar] [CrossRef] [PubMed]
[20] Yang, Y., Gao, F., Ma, X., Yang, L., Wang, Z. and Zhou, Y. (2025) Stress Hyperglycemia Ratio and Albumin Predict In-Hospital Outcomes in Patients with Acute Myocardial Infarction: A Cohort Study. Scientific Reports, 15, Article No. 42679. [Google Scholar] [CrossRef] 
[21] Huang, S., Gao, F., Huang, W., Xiong, C. and Zheng, J. (2024) Association between Stress Hyperglycemia Ratio and Mortality in Acute Myocardial Infarction Patients with and without Atrial Fibrillation: A Retrospective Cohort Study from the MIMIC-IV Database. BMC Cardiovascular Disorders, 24, Article No. 675. [Google Scholar] [CrossRef] [PubMed]
[22] Lai, W., Peng, X.Y., Peng, H. and Chen, Y. (2025) Stress Hyperglycemia Ratio Outperforms Glycemic Variability in Predicting Mortality among Acute Myocardial Infarction Patients with Reduced Ejection Fraction: A Retrospective Cohort Study. Journal of Diabetes, 17, e70122. [Google Scholar] [CrossRef] [PubMed]
[23] Li, J., Xue, L., Chen, R., Liu, C., Zhou, P., Chen, Y., et al. (2025) Prognostic Value of Stress Hyperglycemia Ratio in Patients with Different Plaque Types with Acute Myocardial Infarction. European Journal of Medical Research, 31, Article No. 19. [Google Scholar] [CrossRef] 
[24] Akdeniz, E., Yıldız, C., Karaca, M., Pişirici, M., Sinoplu, H.A., Akpınar, O., et al. (2025) Stress Hyperglycemia Ratio as a Predictor of In-Hospital Stent Thrombosis in STEMI Patients Undergoing Primary PCI: A Retrospective Cohort Study. Medicina, 61, Article 1158. [Google Scholar] [CrossRef] [PubMed]
[25] Bo, K., Li, W., Zhang, H., Wang, Y., Zhou, Z., Gao, Y., et al. (2024) Association of Stress Hyperglycemia Ratio with Left Ventricular Function and Microvascular Obstruction in Patients with ST-Segment Elevation Myocardial Infarction: A 3.0 T Cardiac Magnetic Resonance Study. Cardiovascular Diabetology, 23, Article No. 179. [Google Scholar] [CrossRef] [PubMed]
[26] Zhao, H., Tao, Z., Wang, X., Li, X., Chang, H., Ji, D., et al. (2026) Fasting Stress Hyperglycemia Ratio as a Predictor of Intramyocardial Hemorrhage and Adverse Outcomes in ST-Segment Elevation Myocardial Infarction. Frontiers in Endocrinology, 17, Article 1761471. [Google Scholar] [CrossRef] 
[27] Armillotta, M., Bergamaschi, L., Angeli, F., Belmonte, M., Casuso Alvarez, M., Sansonetti, A., et al. (2025) Impact of Glucometabolic Status on Type 4a Myocardial Infarction in Patients with Non-ST-Segment Elevation Myocardial Infarction: The Role of Stress Hyperglycemia Ratio. Cardiovascular Diabetology, 24, Article No. 394. [Google Scholar] [CrossRef] 
[28] Li, X., Qiao, Y., Ruan, L., Xu, S., Fan, Z., Liu, S., et al. (2025) Stress Hyperglycemia Ratio as an Independent Predictor of Acute Kidney Injury in Critically Ill Patients with Acute Myocardial Infarction: A Retrospective U.S. Cohort Study. Renal Failure, 47, Article ID: 2471018. [Google Scholar] [CrossRef] [PubMed]
[29] Yang, J., Zheng, Y., Li, C., Gao, J., Meng, X., Zhang, K., et al. (2022) The Impact of the Stress Hyperglycemia Ratio on Short-Term and Long-Term Poor Prognosis in Patients with Acute Coronary Syndrome: Insight from a Large Cohort Study in Asia. Diabetes Care, 45, 947-956. [Google Scholar] [CrossRef] [PubMed]
[30] Cao, T., Liu, F., Yao, Y., Sun, D., Wang, R., Cao, J., et al. (2024) A Novel Scale System Based on the Frailty Index and Laboratory Indicators for the Short-Term Prognosis of Patients with Acute Myocardial Infarction: A Retrospective Cohort Study. Clinical Interventions in Aging, 19, 1597-1606. [Google Scholar] [CrossRef] [PubMed]
[31] Xu, W., Yang, Y., Zhu, J., Wu, S., Wang, J., Zhang, H., et al. (2022) Predictive Value of the Stress Hyperglycemia Ratio in Patients with Acute ST-Segment Elevation Myocardial Infarction: Insights from a Multi-Center Observational Study. Cardiovascular Diabetology, 21, Article No. 48. [Google Scholar] [CrossRef] [PubMed]
[32] Luo, J., Xu, S., Li, H., Li, Z., Gong, M., Qin, X., et al. (2022) Prognostic Impact of Stress Hyperglycemia Ratio in Acute Myocardial Infarction Patients with and without Diabetes Mellitus. Nutrition, Metabolism and Cardiovascular Diseases, 32, 2356-2366. [Google Scholar] [CrossRef] [PubMed]
[33] Agarwal, D., Welsch, M.A., Keller, J.N. and Francis, J. (2011) Chronic Exercise Modulates RAS Components and Improves Balance between Pro-and Anti-Inflammatory Cytokines in the Brain of Shr. Basic Research in Cardiology, 106, 1069-1085. [Google Scholar] [CrossRef] [PubMed]
[34] Chu, J., Tang, J., Lai, Y., Gao, Y., Ye, Z., Guan, C., et al. (2020) Association of Stress Hyperglycemia Ratio with Intracoronary Thrombus Burden in Diabetic Patients with ST-Segment Elevation Myocardial Infarction. Journal of Thoracic Disease, 12, 6598-6608. [Google Scholar] [CrossRef] [PubMed]
[35] Bantidos, M.G., Stalikas, N., Fyntanidou, B., Skalidis, I., Arvanitaki, A., Kofos, C., et al. (2025) The Role of Stress-Induced Hyperglycemia in Acute Coronary Syndromes: Pathophysiology, Novel Markers and Clinical Implications. Expert Review of Cardiovascular Therapy, 23, 723-742. [Google Scholar] [CrossRef] 

为你推荐