Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Eur Neurol. 2013;70(3-4):225-32. doi: 10.1159/000351356. Epub 2013 Aug 31.
To investigate the association of hemoglobin A1c (HbA1c) with acute diffusion-weighted imaging lesion volumes (DIV) and early neurologic deterioration (END) in brainstem infarctions (BSIs).
152 patients with acute BSIs were included in this study. The relationship between HbA1c and DIV quartiles was examined. Data considered potentially associated with HbA1c and END after admission and patients' symptomatic changes prior to admission were collected.
There was a significant correlation between HbA1c (%) and DIV (Spearman ρ=0.201, p=0.013). The median HbA1c (%) values for successive DIV quartiles (lowest to highest quartile) were as follows: 5.90, 6.35, 6.25, and 7.50 (p=0.033). The incidence of diabetes mellitus had a significant association with DIV quartiles (p=0.042). HbA1c was significantly associated with symptomatic progression prior to admission (p=0.015). 29 patients developed END after admission. Age, HbA1c, systolic blood pressure, and fibrinogen were significantly associated with END. On logistic regression analysis, HbA1c and fibrinogen proved to be independent variables.
HbA1c may be a possible predictor for ischemic severity, early deterioration of acute BSIs, and short-term prognosis. Long-term good glycemic control is very important in BSIs. Further studies are warranted to confirm these results.
探讨糖化血红蛋白（HbA1c）与脑干梗死（BSI）患者急性弥散加权成像病灶体积（DIV）和早期神经功能恶化（END）的关系。
本研究纳入了 152 例急性 BSI 患者。研究考察了 HbA1c 与 DIV 四分位间距之间的关系。收集了入院后可能与 HbA1c 和 END 相关的数据，以及患者入院前的症状变化。
HbA1c（%）与 DIV 之间存在显著相关性（Spearman ρ=0.201，p=0.013）。连续 DIV 四分位间距（从最低到最高四分位间距）的 HbA1c（%）中位数分别为：5.90、6.35、6.25 和 7.50（p=0.033）。糖尿病的发生率与 DIV 四分位间距有显著相关性（p=0.042）。HbA1c 与入院前症状进展显著相关（p=0.015）。29 例患者在入院后发生 END。年龄、HbA1c、收缩压和纤维蛋白原与 END 显著相关。在逻辑回归分析中，HbA1c 和纤维蛋白原被证明是独立变量。
HbA1c 可能是预测 BSIs 患者缺血严重程度、早期恶化和短期预后的一个指标。长期良好的血糖控制对 BSI 非常重要。需要进一步的研究来证实这些结果。
