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血管内血栓切除术治疗后缺血性卒中患者血清葡萄糖与钾比值与临床结局的关系

Association between the serum glucose-to-potassium ratio and clinical outcomes in ischemic stroke patients after endovascular thrombectomy.

作者信息

Zhang Qianqian, Huang Zhihang, Chen Shuaiyu, Yan E, Zhang Xiaohao, Su Mouxiao, Zhou Junshan, Wang Wei

机构信息

Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Department of Neurology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.

出版信息

Front Neurol. 2024 Oct 1;15:1463365. doi: 10.3389/fneur.2024.1463365. eCollection 2024.

Abstract

BACKGROUND AND PURPOSE

The baseline glucose-to-potassium ratio (GPR) is associated with poor outcomes in patients with acute brain injury and intracranial hemorrhage. However, the impact of serum GPR on clinical outcomes after endovascular thrombectomy (EVT) is unclear. This study aimed to evaluate the association between the GPR at admission and functional outcomes at 90 days after EVT.

METHODS

We retrospectively reviewed our database for patients with acute ischemic stroke involving an anterior circulation large-vessel occlusion who received EVT between October 2019 and December 2021. The baseline serum GPR was measured after admission. The primary outcome was a 90-day poor outcome, which was defined as a modified Rankin scale score of 3-6.

RESULTS

A total of 273 patients (mean age, 70.9 ± 11.9 years; 161 men) were finally included for analyses. During the 90-day follow-up, 151 patients (55.3%) experienced an unfavorable outcome. After adjusting for demographic characteristics and other potential confounders, the increased GPR was significantly associated with a higher risk of a 90-day poor outcome (odds ratio, 1.852; 95% confidence interval, 1.276-2.688,  = 0.001). Similar results were observed when the GPR was analyzed as a categorical variable. In addition, the restricted cubic spline observed a positive and linear association between the GPR and poor outcomes at 90 days ( = 0.329 for linearity;  = 0.001 for linearity).

CONCLUSION

Our study found that ischemic stroke patients with the higher GPR at admission were more likely to have an unfavorable prognosis at 3 months, suggesting that GPR may be a potential prognostic biomarker for ischemic stroke after EVT.

摘要

背景与目的

基线血糖与血钾比值(GPR)与急性脑损伤和颅内出血患者的不良预后相关。然而,血清GPR对血管内血栓切除术(EVT)后临床结局的影响尚不清楚。本研究旨在评估入院时的GPR与EVT后90天功能结局之间的关联。

方法

我们回顾性分析了2019年10月至2021年12月期间接受EVT治疗的急性缺血性卒中且累及前循环大血管闭塞患者的数据库。入院后测量基线血清GPR。主要结局为90天不良结局,定义为改良Rankin量表评分为3 - 6分。

结果

最终纳入273例患者进行分析(平均年龄70.9±11.9岁;男性161例)。在90天随访期间,151例患者(55.3%)出现不良结局。在调整人口统计学特征和其他潜在混杂因素后,GPR升高与90天不良结局风险显著增加相关(比值比,1.852;95%置信区间,1.276 - 2.688,P = 0.001)。将GPR作为分类变量分析时观察到类似结果。此外,受限立方样条分析显示GPR与90天不良结局之间存在正线性关联(线性检验P = 0.329;线性检验P = 0.001)。

结论

我们的研究发现,入院时GPR较高的缺血性卒中患者在3个月时更可能预后不良,提示GPR可能是EVT后缺血性卒中的潜在预后生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f8/11473311/303ce2eacf54/fneur-15-1463365-g001.jpg

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