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急性腔隙性脑梗死患者的高血糖:一项中国医院的研究。

Hyperglycaemia in acute lacunar stroke: a Chinese hospital-based study.

机构信息

Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.

出版信息

Diab Vasc Dis Res. 2013 May;10(3):216-21. doi: 10.1177/1479164112459663. Epub 2012 Oct 18.

Abstract

Admission hyperglycaemia is very common in acute ischaemic stroke (IS) patients and is associated with worse outcome in non-lacunar infarction, but its association with lacunar infarction remains controversial. We investigated the association between hyperglycaemia and clinical outcome in patients with acute lacunar stroke in a hospitalised Chinese population. Consecutive patients with acute IS were enrolled and classified into lacunar and non-lacunar stroke groups based on clinical criteria according to the Oxfordshire Community Stroke Project (OCSP) and findings on brain computed tomography (CT) or magnetic resonance imaging (MRI) scan. Hyperglycaemia was defined as blood glucose > 6.1 mmol/L. Univariate and multivariate analyses were used to examine the association between hyperglycaemia and outcomes in diabetic and non-diabetic groups. The main outcome measure was a poor outcome [defined as modified Rankin Scale (mRS) score ≥ 3] at 12 months after stroke. Of the 2020 acute ISs, 689 (34.1%) were acute lacunar strokes, of which 159 (23%) were diabetic and the other 530 (77%) were non-diabetic. In non-lacunar stroke, admission hyperglycaemia was independently associated with increased risk of poor outcome at 1 year (odds ratio (OR) = 1.782; 95% confidence interval (CI) = 1.340-2.370, p = 0.0005). In lacunar stroke, hyperglycaemia was not associated with functional outcome (OR = 1.337; 95% CI = 0.939-1.093, p = 0.086) irrespective of the diabetic status.

摘要

入院时高血糖在急性缺血性脑卒中(IS)患者中非常常见,与非腔隙性梗死患者的预后较差相关,但与腔隙性梗死的相关性仍存在争议。我们在中国住院人群中调查了急性腔隙性脑卒中患者高血糖与临床结局的关系。连续纳入急性 IS 患者,并根据临床标准(根据牛津社区卒中项目(OCSP)和脑计算机断层扫描(CT)或磁共振成像(MRI)扫描结果)将其分为腔隙性和非腔隙性卒中组。高血糖定义为血糖>6.1mmol/L。采用单变量和多变量分析检查糖尿病和非糖尿病组中高血糖与结局的关系。主要结局测量是卒中后 12 个月时的不良结局(定义为改良 Rankin 量表(mRS)评分≥3)。在 2020 例急性 IS 中,689 例(34.1%)为急性腔隙性脑卒中,其中 159 例(23%)为糖尿病,其余 530 例(77%)为非糖尿病。在非腔隙性卒中组中,入院时高血糖与 1 年时不良结局风险增加独立相关(优势比(OR)=1.782;95%置信区间(CI)=1.340-2.370,p=0.0005)。在腔隙性卒中组中,无论糖尿病状态如何,高血糖与功能结局均无相关性(OR=1.337;95%CI=0.939-1.093,p=0.086)。

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