Luo Bin, Xiang Yi, Meng Fanlei, Wang Yubo, Zhang Zhenzhong, Ren Hecheng, Ma Lin
Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.
Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin, China.
Front Neurol. 2024 Oct 23;15:1422851. doi: 10.3389/fneur.2024.1422851. eCollection 2024.
To analyze the effect of fasting blood glucose levels after reperfusion of acute large vessel occlusion (ALVO) on patient functional prognosis.
Retrospectively included ALVO patients from three large stroke centers in China, all of whom achieved vascular reperfusion after mechanical thrombectomy or bridging thrombolysis. The prognosis scores of all patients at 90 ± 7 days post-recanalization were categorized into a good prognosis group (mRS 0-2) and a poor prognosis group (mRS 3-6). The relationship between mean blood glucose levels at 72 h post-recanalization and prognosis was explored using multivariable logistic regression analysis. Then we measured the area under the ROC curve for all factors to assess their predictive performance.
(1) Totally 2,056 patients were included in the study, with 1,488 males and 568 females. There were 1,370 patients in the good prognosis group (mRS 0-2) and 686 in the poor prognosis group (mRS 3-6). (2) The two groups exhibited significant differences in terms of age, preoperative mRS score, history of diabetes, and mean fasting blood glucose (MFBG) ( < 0.001). (3) With 90-day mRS as the outcome variable, all independent variables were included in Univariate and multivariate regression analyses analysis, and the results showed that: age, preoperative mRS score, history of diabetes, and MFBG are all independent predictors of prognosis after recanalization of ALVO, with MFBG demonstrating a higher predictive power than the other factors (AUC = 0.644).
Various factors are correlated with the prognosis in patients who have undergone ALVO recanalization. Notably, the MFBG level demonstrates a significant predictive value for outcomes within the first 72 h following the recanalization procedure.
分析急性大血管闭塞（ALVO）再灌注后空腹血糖水平对患者功能预后的影响。
回顾性纳入来自中国三个大型卒中中心的ALVO患者，所有患者均在机械取栓或桥接溶栓后实现血管再灌注。将所有患者再通后90±7天的预后评分分为预后良好组（mRS 0-2）和预后不良组（mRS 3-6）。采用多变量逻辑回归分析探讨再通后72小时平均血糖水平与预后的关系。然后我们测量了所有因素的ROC曲线下面积，以评估它们的预测性能。
（1）本研究共纳入2056例患者，其中男性1488例，女性568例。预后良好组（mRS 0-2）有1370例患者，预后不良组（mRS 3-6）有686例患者。（2）两组在年龄、术前mRS评分、糖尿病史和平均空腹血糖（MFBG）方面存在显著差异（<0.001）。（3）以90天mRS作为结局变量，将所有自变量纳入单变量和多变量回归分析，结果显示：年龄、术前mRS评分、糖尿病史和MFBG均为ALVO再通后预后的独立预测因素，其中MFBG的预测能力高于其他因素（AUC = 0.644）。
多种因素与接受ALVO再通治疗患者的预后相关。值得注意的是，MFBG水平对再通术后前72小时的结局具有显著的预测价值。
