Stroke:机械性血栓切除术治疗的大血管闭塞患者HbA1c与临床结局的关系

2018-12-01 xing.T MedSci原创

这些结果表明,在采用MT治疗的大血管闭塞患者中,较高HbA1c水平是AIS后3个月不良预后的独立预测因子,特别是在血管再通的患者中,并且可能增加AIS后死亡和早期临床恶化的风险。

近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员分析了机械血栓切除术(MT)治疗大血管闭塞患者的糖化血红蛋白(HbA1c)水平与临床结局之间的关系。

该前瞻性队列研究共纳入了534例接受MT治疗的急性缺血性卒中(AIS)患者。根据HbA1c水平,测量的主要结局是3个月时改良的Rankin量表评分。高HbA1c水平定义为血浆HbA1c>6.5%。有利结局被定义为功能独立,改良Rankin量表评分为0至2。次要功能结局包括死亡率、早期临床结局和颅内出血。

研究人员发现HbA1c>6.5%的患者结局良好的患者比例明显低于HbA1c≤6.5%的患者比例(28.8% vs. 42.1%; P=0.006)。在多变量分析中,高剂量的HbA1c水平(特别是HbA1c>7.0%)与采用MT治疗大血管闭塞的患者AIS后3个月的功能不良结局显著相关。在用MT治疗的患者中,较高HbA1c也与AIS后死亡率增加和早期临床结局显著相关。亚组分析显示,与再通组和非再通组患者相比,HbA1c>6.5%与AIS后3个月功能独立的几率显著降低相关。

这些结果表明,在采用MT治疗的大血管闭塞患者中,较高HbA1c水平是AIS后3个月不良预后的独立预测因子,特别是在血管再通的患者中,并且可能增加AIS后死亡和早期临床恶化的风险。

原始出处:

Kang-Ho Choi,et al.HbA1c (Glycated Hemoglobin) Levels and Clinical Outcome Post-Mechanical Thrombectomy in Patients With Large Vessel Occlusion.Stroke. 2018. https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.021598

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    2019-06-15 kkunny
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    2019-01-07 智智灵药
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    2018-12-01 龙胆草

    学习谢谢分享

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