Qureshi Adnan I, Huang Wei, Lobanova Iryna, Chandrasekaran Premkumar N, Hanley Daniel F, Hsu Chung Y, Martin Renee H, Steiner Thorsten, Suarez Jose I, Yamamoto Haruko, Toyoda Kazunori
Zeenat Qureshi Stroke Institute, St Cloud, MN (A.I.Q., W.H., I.L.).
Department of Neurology, University of Missouri, Columbia (A.I.Q., W.H., I.L., P.N.C.).
Stroke. 2022 Apr;53(4):1226-1234. doi: 10.1161/STROKEAHA.121.034928. Epub 2021 Nov 30.
We evaluated the effect of persistent hyperglycemia on outcomes in 1000 patients with intracerebral hemorrhage enrolled within 4.5 hours of symptom onset.
We defined moderate and severe hyperglycemia based on serum glucose levels ≥140 mg/dL-<180 and ≥180 mg/dL, respectively, measured at baseline, 24, 48, and 72 hours. Persistent hyperglycemia was defined by 2 consecutive (24 hours apart) serum glucose levels. We evaluated the relationship between moderate and severe hyperglycemia and death or disability (defined by modified Rankin Scale score of 4-6) at 90 days in the overall cohort and in groups defined by preexisting diabetes.
In the multivariate analysis, both moderate (odds ratio, 1.8 [95% CI, 1.1-2.8]) and severe (odds ratio, 1.8 [95% CI, 1.2-2.7]) hyperglycemia were associated with higher 90-day death or disability after adjusting for Glasgow Coma Scale score, hematoma volume, presence or absence of intraventricular hemorrhage, hyperlipidemia, cigarette smoking, and hypertension (no interaction between hyperglycemia and preexisting diabetes, =0.996). Among the patients without preexisting diabetes, both moderate (odds ratio, 1.8 [95% CI, 1.0-3.2]) and severe (odds ratio, 2.0 [95% CI, 1.1-3.7]) hyperglycemia were associated with 90-day death or disability after adjusting for above mentioned potential confounders. Among the patients with preexisting diabetes, moderate and severe hyperglycemia were not associated with 90-day death or disability.
Persistent hyperglycemia, either moderate or severe, increased the risk of death or disability in nondiabetic patients with intracerebral hemorrhage.
URL: https://www.
gov; Unique identifier: NCT01176565.
我们评估了症状发作4.5小时内入组的1000例脑出血患者持续性高血糖对预后的影响。
我们根据基线、24小时、48小时和72小时测得的血清葡萄糖水平分别≥140mg/dL-<180mg/dL和≥180mg/dL来定义中度和重度高血糖。持续性高血糖由连续两次（间隔24小时）的血清葡萄糖水平定义。我们评估了总体队列以及根据既往糖尿病定义的亚组中，中度和重度高血糖与90天时死亡或残疾（改良Rankin量表评分为4 - 6定义）之间的关系。
在多变量分析中，校正格拉斯哥昏迷量表评分、血肿体积、是否存在脑室内出血、高脂血症、吸烟和高血压后，中度（比值比，1.8 [95%CI，1.1 - 2.8]）和重度（比值比，1.8 [95%CI，1.2 - 2.7]）高血糖均与90天死亡或残疾风险增加相关（高血糖与既往糖尿病之间无交互作用，P = 0.996）。在无既往糖尿病的患者中，校正上述潜在混杂因素后，中度（比值比，1.8 [95%CI，1.0 - 3.2]）和重度（比值比，2.0 [95%CI，1.1 - 3.7]）高血糖均与90天死亡或残疾相关。在有既往糖尿病的患者中，中度和重度高血糖与90天死亡或残疾无关。
中度或重度持续性高血糖会增加非糖尿病脑出血患者的死亡或残疾风险。
网址：https://www.
gov；唯一标识符：NCT01176565。
