血糖水平是否会影响急性缺血性脑卒中患者接受静脉溶栓治疗后的预后？一项荟萃分析。
Blood glucose level affects prognosis of patients who received intravenous thrombolysis after acute ischemic stroke? A meta-analysis.
机构信息
Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
Front Endocrinol (Lausanne). 2023 Apr 12;14:1120779. doi: 10.3389/fendo.2023.1120779. eCollection 2023.
BACKGROUND AND OBJECTIVES
Intravenous recombinant tissue plasminogen activator (rtPA) thrombolysis is an effective treatment for acute ischemic stroke. Hyperglycemia is a major risk factor for the occurrence, development, and prognosis of ischemic stroke. This meta-analysis purposefully estimates the association between hyperglycemia and poor prognosis in acute ischemic stroke patients receiving intravenous rtPA thrombolytic therapy.
MATERIALS AND METHODS
According to the predefined inclusion criteria, we searched PubMed, Web of Science, and Cochrane Library databases. The association of high blood glucose(>140mg/dl) with symptomatic intracranial hemorrhage (sICH), poor clinical outcome and mortality at 90 days post-rtPA thrombolysis was studied using both a common effects model and a random effects model. Odds ratios (ORs) were plotted on forest plots.
RESULTS
Of a total cohort of 2565 patients who received intravenous thrombolytic therapy, 721 had higher blood glucose. High glucose level significantly increased the odds of sICH (OR 1.80; 95% confidence interval(95%CI): 1.30- 2.50) and poor clinical outcome at 90 days (OR 1.82; 95%CI: 1.52-2.19), and all-cause mortality at 90 days (OR 2.51; 95%CI:1.65-3.82).
CONCLUSIONS
In our meta-analysis, high blood glucose was significantly associated with sICH, poor clinical outcome and higher mortality at 90 days.
背景与目的
静脉注射重组组织型纤溶酶原激活物（rtPA）溶栓治疗是急性缺血性脑卒中的有效治疗方法。高血糖是缺血性脑卒中发生、发展和预后的主要危险因素。本荟萃分析旨在评估急性缺血性脑卒中患者接受静脉 rtPA 溶栓治疗后高血糖与预后不良的关系。
材料与方法
根据预设的纳入标准，我们检索了 PubMed、Web of Science 和 Cochrane Library 数据库。使用固定效应模型和随机效应模型研究了高血糖（>140mg/dl）与症状性颅内出血（sICH）、rtPA 溶栓后 90 天临床预后不良和死亡率的关系。比值比（OR）绘制在森林图上。
结果
在接受静脉溶栓治疗的 2565 例患者中，共有 721 例血糖升高。高血糖水平显著增加了 sICH 的发生风险（OR 1.80；95%置信区间[95%CI]：1.30-2.50）和 rtPA 溶栓后 90 天的临床预后不良（OR 1.82；95%CI：1.52-2.19），以及 rtPA 溶栓后 90 天的全因死亡率（OR 2.51；95%CI：1.65-3.82）。
结论
在我们的荟萃分析中，高血糖与 sICH、临床预后不良和 90 天死亡率显著相关。
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