Wang Yu, Wang Xi-Xi, Zhang Yu-Lei, Song Jia-Ming, Zhou Kai-Ze, Zhang Jun-Fang, Wang Guo-Dong, Li Xin-Jun, Feng Ya, Wu Yun-Cheng
Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Center for Primary Health Care Research, Lund University, Lund, Sweden.
JRSM Cardiovasc Dis. 2025 Aug 19;14:20480040251365373. doi: 10.1177/20480040251365373. eCollection 2025 Jan-Dec.
This study aimed to investigate the relationship between the stress hyperglycaemia ratio and haemorrhagic transformation after intravenous thrombolysis in acute ischaemic stroke patients.
We analysed data in Shanghai General Hospital from 2019 to 2022 on 161 men and 68 women with valid data on fasting blood glucose, glycated haemoglobin, and cranial computed tomography using multivariable regression models to examine the relationship between hyperglycaemia ratio and haemorrhagic transformation.
All 229 patients in this study were included, with 161 males (70.3%) and a mean age of 69.0 (SD = 11.3). According to the median hyperglycaemia ratio (0.87), all patients were divided into two groups (M1 ≤ 0.87). Patients in the M2 group tended to have a higher fasting blood glucose, body mass index, glycated albumin, and apolipoprotein E, while the door-to-needle time in M2 was longer than in M1 (all values < 0.05). The fasting blood glucose, hyperglycaemia ratio, urea nitrogen, glycated albumin, D-dimer, and the score of NIHSS in the haemorrhagic transformation group were higher than in the non-haemorrhagic transformation group, but the haemoglobin was lower (all values < 0.05). In the overall population, the hyperglycaemia ratio was associated with haemorrhagic transformation after intravenous thrombolysis before and after full adjustment for age, sex, body mass index, hyperglycaemia ratio, glycated albumin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein E, door-to-needle time and the score of National Institute of Health Stroke Scale [OR = 3.34, 95% CI: 1.27-7.76].
This result implied that the hyperglycaemia ratio is significantly associated with haemorrhagic transformation after intravenous thrombolysis in stroke patients. The stress hyperglycaemia ratio should be borne in mind after intravenous thrombolysis regarding the incidence of haemorrhagic transformation.
本研究旨在探讨急性缺血性脑卒中患者静脉溶栓后应激性高血糖比率与出血性转化之间的关系。
我们分析了上海交通大学医学院附属新华医院2019年至2022年期间161名男性和68名女性患者的数据，这些患者有空腹血糖、糖化血红蛋白和头颅计算机断层扫描的有效数据，使用多变量回归模型来研究高血糖比率与出血性转化之间的关系。
本研究共纳入229例患者，其中男性161例（70.3%），平均年龄69.0岁（标准差=11.3）。根据高血糖比率中位数（0.87），将所有患者分为两组（M1≤0.87）。M2组患者的空腹血糖、体重指数、糖化白蛋白和载脂蛋白E往往较高，而M2组的门-针时间比M1组长（所有P值<0.05）。出血性转化组的空腹血糖、高血糖比率、尿素氮、糖化白蛋白、D-二聚体和美国国立卫生研究院卒中量表（NIHSS）评分高于非出血性转化组，但血红蛋白较低（所有P值<0.05）。在总体人群中，在对年龄、性别、体重指数、高血糖比率、糖化白蛋白、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇载脂蛋白E、门-针时间和美国国立卫生研究院卒中量表评分进行全面调整前后，高血糖比率与静脉溶栓后的出血性转化相关[比值比（OR）=3.34，95%置信区间（CI）：1.27-7.76]。
该结果表明，高血糖比率与脑卒中患者静脉溶栓后的出血性转化显著相关。静脉溶栓后应考虑应激性高血糖比率对出血性转化发生率的影响。
