天坛医院研究称,应激性高血糖患者中风复发危险增加

2017-10-30 许菁 中国循环杂志

天坛医院王伊龙等发表CHANCE研究亚组分析最新结果:发生严重的应激性高血糖的轻度急性缺血性卒中患者再次卒中风险是血糖稍低或者没有糖尿病的1.5倍。 研究者采用葡萄糖/糖化白蛋白比值定义应激高血糖。研究者指出,临床上一般采用以往无糖尿病患者出现高血糖或者以往有糖尿病而出现血糖极度升高来诊断应激性高血糖。这种诊断方式不容易区分应激性高血糖还是新诊断糖尿病。相比之下,葡萄糖/糖化白蛋白比值定

天坛医院王伊龙等发表CHANCE研究亚组分析最新结果:发生严重的应激性高血糖的轻度急性缺血性卒中患者再次卒中风险是血糖稍低或者没有糖尿病的1.5倍。
 
研究者采用葡萄糖/糖化白蛋白比值定义应激高血糖。

研究者指出,临床上一般采用以往无糖尿病患者出现高血糖或者以往有糖尿病而出现血糖极度升高来诊断应激性高血糖。这种诊断方式不容易区分应激性高血糖还是新诊断糖尿病。

相比之下,葡萄糖/糖化白蛋白比值定量测量了血浆葡萄糖浓度较前葡萄糖状态的急性升高。
 
纳入了3026例轻度急性缺血性卒中或短暂性脑缺血发作患者,3个月内再次新发卒中299例,再次卒中发生率为9.9%。
 
葡萄糖/糖化白蛋白比值<0.290的患者和>0.385的患者的二次卒中发生率分别为9.2%和12.0% 。
 
进一步分析显示,与<0.290相比,葡萄糖/糖化白蛋白比值>0.385的患者3个月内再次卒中发生风险增加46%。
 
研究证实,再次卒中发生的葡萄糖/糖化白蛋白比值的阈值为0.29。
 
来源:Yuesong Pan, Xueli Cai, Jing Jing, et al. Stress Hyperglycemia and Prognosis of Minor Ischemic Stroke and Transient Ischemic Attack:The CHANCE Study (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events). Stroke. 2017.Originally published October 19, 2017.

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