Higher Fasting Glucose Next Day after Intravenous Thrombolysis Is Independently Associated with Poor Outcome in Acute Ischemic Stroke
Higher Fasting Glucose Next Day after Intravenous Thrombolysis Is Independently Associated with Poor Outcome in Acute Ischemic Stroke
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静脉溶栓后第二天空腹血糖升高与急性缺血性中风的不良结局独立相关
DOI：
10.1016/j.jstrokecerebrovasdis.2014.07.029
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发表时间：
2015-01-01
影响因子：
2.5
通讯作者：
Dong, Qiang
中科院分区：
文献类型：
--
作者：
Cao, Wenjie;Ling, Yifeng;Dong, Qiang
背景资料：我们的目的是测试静脉溶栓（IVT）急性缺血性卒中（AIS）患者发病后第二天获得的常规空腹血糖（FG）的预后预测能力。研究方法：我们从前瞻性记录的卒中数据库中确定了2011年12月至2013年7月在发病后4.5小时内到我们机构就诊的AIS患者，这些患者在IVT前接受了入院血糖（AG）、FG和入院后第二天的糖化血红蛋白（HbA 1c）。采用多因素Logistic回归分析FG与90天改良兰金量表（mRS）的相关性。结果：2011年12月至2013年7月期间，共有166例AIS患者接受静脉注射纤溶酶原激活剂。其中，119例患者在IVT前有AG，第二天有FG和HbA 1c。FG独立预测90天临床不良结局（mRS，3-6，比值比为1.576; 95%置信区间[ CI]，1.0532.358; P = .027）。这种关联在AG（P = .714）、HbA 1c（P = .655）和糖尿病史（P = .547）中不显著。在受试者操作特征分析中，FG增加与90天mRS（3-6）相关，曲线下面积为0.72，（95% CI，0.65 - 0.65）。9; P = .001）。结论：FG是独立于AG和HbA 1c的与IVT治疗的AIS患者的结局相关的强有力的预测因子。(C)2015年：National Stroke Association
Background: We aimed to test the outcome-predictive power of routine fasting glucose (FG) obtained at second day after onset in intravenous thrombolysis (IVT) acute ischemic stroke (AIS) patients. Methods: We identified AIS patients presenting to our institution between December 2011 and July 2013 within 4.5 hours of onset, who received admission glucose (AG) before IVT, FG, and glycated hemoglobin (HbA1c) the second day after admission, from our prospectively recorded stroke database. Multivariate logistic regression was used to assess the association of FG and 90-day modified Rankin Scale (mRS). Results: Between December 2011 and July 2013, a total of 166 AIS patients received intravenous plasminogen activator. Of those, 119 patients who have AG before IVT, FG, and HbA1c the second day were included in the study. FG independently predicted 90-day clinical unfavorable outcome (mRS, 3-6 with an odds ratio of 1.576; 95% confidence interval [ CI], 1.0532.358; P = .027). This association was not significant in AG (P = .714), HbA1c (P = .655), and history of diabetes (P = .547). In receiver operating characteristic analysis, increased FG was associated with 90-day mRS (3-6) with an area under curve of.72, (95% CI,.65-. 9; P = .001). Conclusions: FG is a powerful predictor associated with the outcome in IVT-treated AIS patients independent ofAGand HbA1c. (C) 2015 by National Stroke Association