应激性高血糖是围术期危重症患者普遍存在的代谢紊乱现象。然而单一的血糖指标易受到多种因素影响，难以评估患者的应激状态。应激性高血糖比率（stress hyperglycemia rate， SHR）作为一项新兴指标，采用入院血糖与慢性平均血糖计算，可有效区分应激性高血糖与糖尿病相关高血糖。现有研究表明，SHR在急性心肌梗死、脑卒中、脓毒症等多种危重症人群中，对不良心血管事件、病死率和功能恢复不良等主要预后终点均表现出显著的预测能力，其准确性优于单一血糖指标。本文旨在系统阐明SHR在评估危重症患者不良预后风险中的预测价值及相关证据，深入理解SHR的价值，为危重症患者的风险分层、个体化管理以及改善预后提供了新的视角和潜在干预靶点。

Stress hyperglycemia is a common metabolic disturbance observed in critically ill patients during the perioperative period. However， the use of a single blood glucose measurement is susceptible to various confounding factors and may not accurately reflect the patient's stress status. The Stress Hyperglycemia Ratio （SHR）， an emerging biomarker， is calculated by comparing admission blood glucose levels with the individual's estimated chronic average glycemic level， thereby enabling a more accurate differentiation between stress-induced hyperglycemia and hyperglycemia associated with pre-existing diabetes. Accumulating evidence indicates that SHR demonstrates significant predictive value for major adverse clinical outcomes， including cardiovascular events， mortality， and impaired functional recovery， across diverse critically ill populations such as those with acute myocardial infarction， stroke， and sepsis. Moreover， SHR has been shown to outperform traditional single blood glucose measurements in terms of prognostic accuracy. This review aims to systematically summarize the current evidence regarding the predictive utility of SHR in risk assessment for adverse outcomes among critically ill patients. By enhancing our understanding of SHR's clinical relevance， this review seeks to provide insights into novel approaches for risk stratification， individualized patient management， and ultimately， improved clinical outcomes.