Stroke:高血糖与缺血性卒中患者血管内治疗后不良结局相关

2020-10-15 MedSci原创 MedSci原创

入院血糖升高与功能不良和血管内治疗后症状性颅内出血风险增加有关。

入院时高血糖可预示卒中后预后不良。近日,血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员评估了接受血管内治疗的患者血糖浓度与患者临床结局之间的关联。

研究人员选择了前前循环大血管闭塞的成年患者,这些患者接受了血管内治疗,并获得入院血糖数据。研究人员评估了入院血糖与90天改良的Rankin量表评分、有症状颅内出血和成功再灌注率之间的关联。高血糖定义为入院血糖≥7.8mmol/L。研究人员使用多变量有序Logistic回归评估了血糖与改良Rankin量表之间的关联,并评估了成功再灌注(脑梗塞2b-3扩展溶栓)是否会改变这种关联。

该研究纳入了2908名。入院血糖浓度中位数为6.8 mmol/L(四分位数范围为5.9-8.1),882名(30%)患者伴有高血糖症。与非高血糖患者相比,入院时高血糖与功能恶化(改良Rankin量表评分4分 vs. 3分;调整后的总比值比为1.69 [95%CI为1.44–1.99])、死亡率增加(40% vs. 23%;调整后的比值比为1.95 [95%CI为1.60–2.38])、症状性颅内出血风险增加(9% vs. 5%;调整后的比值比为1.94 [95%CI为1.41-2.66])相关。入院血糖水平与患者不良预后(改良的Rankin量表评分3–6)之间的关联呈J形。高血糖与成功再灌注率无关,成功再灌注也不能改变血糖与功能结局之间的关系。

由此可见,入院血糖升高与功能不良和血管内治疗后症状性颅内出血风险增加有关。

原始出处:

Leon A. Rinkel,et al.High Admission Glucose Is Associated With Poor Outcome After Endovascular Treatment for Ischemic Stroke.stroke.2020.https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.029944

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    2020-12-15 1dedaedcm53(暂无匿称)

    原因是什么详细学习

    0

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    2020-10-17 hbwxf
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    2020-10-15 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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