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代谢综合征与急性缺血性卒中的短期预后:一项基于医院的回顾性研究。

Metabolic syndrome and the short-term prognosis of acute ischemic stroke: a hospital-based retrospective study.

作者信息

Liu Liu, Zhan Lixuan, Wang Yisheng, Bai Chengping, Guo Jianjun, Lin Qingyuan, Liang Donghai, Xu En

机构信息

Institute of Neurosciences and the Second Affiliated Hospital of Guangzhou Medical University; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, 250 Changgang Dong RD, Guangzhou, 510260, People's Republic of China.

Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road, 2040K, Atlanta, GA, 30322, USA.

出版信息

Lipids Health Dis. 2015 Jul 22;14:76. doi: 10.1186/s12944-015-0080-8.

Abstract

BACKGROUND

Metabolic syndrome (MetS) is an important risk factor for cerebral ischemic stroke, yet previous studies on the relationship between MetS or its components and acute cerebral infarction have been inconsistent. This study aims to evaluate the effects of MetS and its components on the short-term prognosis of patients with acute ischemic stroke.

METHODS

Subjects with ischemic stroke of <7-day duration (530 cases) were enrolled. MetS was defined based on the modified criteria of the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Demographic data, vascular risk factors, National Institutes of Health Stroke Scale score, the results of physical, laboratory and imaging examinations and clinical outcomes at 30 and 90 days were recorded. Using univariate analysis, we compared different baseline characteristics between patients with MetS and those without MetS. Further, we assessed MetS and its 5 components on the contribution to short-term prognosis of ischemic stroke with multiple logistic regression models after adjusting for age and sex.

RESULTS

The prevalence of MetS among the patients with acute ischemic stroke in the study is 58.3%, with more in females (70.3%) than in males (49.7%, p < 0.001). As expected, among the MetS components, elevated waist circumference, elevated triglyceride, high fasting blood glucose and low high density lipoprotein cholesterol (HDL-C) were significantly more prevalent in patients with MetS than those without MetS (all p < 0.001). There was no correlation between MetS itself and the short-term prognosis of acute ischemic stroke. Only hyperglycemia in the serum was shown to have impact on poor functional outcomes in 30 and 90 days after the onset of stroke.

CONCLUSIONS

The occurrence of MetS among patients with acute ischemic stroke in our study is 58.3%. MetS itself may not be predictive for the short-term prognosis of patients, while hyperglycemia is a significant predictor for poor functional outcomes in our study.

摘要

背景

代谢综合征(MetS)是脑缺血性卒中的重要危险因素,但先前关于MetS及其组分与急性脑梗死之间关系的研究结果并不一致。本研究旨在评估MetS及其组分对急性缺血性卒中患者短期预后的影响。

方法

纳入病程小于7天的缺血性卒中患者(530例)。MetS根据国际糖尿病联盟以及美国心脏协会/美国国立心肺血液研究所的修订标准进行定义。记录人口统计学数据、血管危险因素、美国国立卫生研究院卒中量表评分、体格检查、实验室检查及影像学检查结果以及30天和90天时的临床结局。采用单因素分析比较MetS患者与非MetS患者之间不同的基线特征。此外,在调整年龄和性别后,我们使用多因素逻辑回归模型评估MetS及其5个组分对缺血性卒中短期预后的影响。

结果

本研究中急性缺血性卒中患者MetS的患病率为58.3%,女性患者(70.3%)多于男性患者(49.7%,p<0.001)。正如预期的那样,在MetS组分中,MetS患者的腰围增加、甘油三酯升高、空腹血糖升高及高密度脂蛋白胆固醇(HDL-C)降低的发生率显著高于非MetS患者(均p<0.001)。MetS本身与急性缺血性卒中的短期预后无相关性。仅血清高血糖被证明对卒中发病后30天和90天的功能预后不良有影响。

结论

本研究中急性缺血性卒中患者MetS的发生率为58.3%。MetS本身可能无法预测患者的短期预后,而高血糖是本研究中功能预后不良的重要预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89d/4511539/1a959830bbca/12944_2015_80_Fig1_HTML.jpg

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