摘要
目的 探讨早期糖化血红蛋白(HbA1c)水平与首次发生急性缺血性卒中(AIS)患者2年预后的关系.方法 选取2018-2019年在该院住院的513例首次发生AIS患者为研究对象.收集患者临床资料、生化指标、出院情况等,多因素logistic回归分析患者2年内不良结局的影响因素,Kaplan-Meier生存曲线分析患者2年内全因死亡和复发卒中情况.结果 不同HbA1c水平患者性别、年龄、TOAST分型,糖尿病、心律失常、冠心病等疾病史,降糖药、降脂药、抗凝剂等用药史,BMI、尿素(Urea)、肌酐(Crea)、ALT、SBP、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、入院时美国国立卫生研究院卒中量表(NIHSS)评分、出院方式、出院时NIHSS评分、住院时间、住院费用比较差异有统计学意义(P＜0.05).多因素logistic回归分析显示,HbA1c＞7.4％是患者2年内不良结局的独立危险因素(OR=4.470,95％CI:1.105～18.087,P=0.036).Kaplan-Meier生存曲线分析显示,不同HbA1c水平患者2年中位生存时间比较差异有统计学意义(P=0.009),HbA1c水平越高,生存时间越短.结论 较高水平HbA1c对首次发生AIS患者2年内复发卒中和全因死亡有影响.
Abstract
Objective To explore the relationship between the early stage HbA1c level and two-year prognosis in the patients with first time onset of acute ischemic stroke(AIS).Methods A total of 513 inpa-tients with first time AIS in this hospital during 2018-2019 were selected as the study subjects.The clinical data,biochemical indicators and discharge situation were collected.The multivariate logistic regression was used to analyze the influencing factors of adverse reactions outcome within 2 years.The Kaplan-Meier survival curve was used to analyze the all-cause mortality and stroke recurrence situation within 2 years.Results The sex,age,TOAST type,,diseases history such as diabetes,arrhythmia and coronary heart disease,medication history such as antidiabetic drugs,lipid-lowering drugs and anticoagulants,BMI,Urea,Crea,ALT,SBP,fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),HDL-C,NIHSS score at admission,discharge mode,NIHSS score at discharge,hospitalization duration and hospitalization costs had statistical difference a-mong the patients with different HbA1c levels(P＜0.05).The multivariate logistic regression analysis showed that HbA1c＞7.4％was the independent risk factor for adverse outcome within 2 years(OR=4.470,95％CI:1.105-18.087,P=0.036).The Kaplan-Meier survival curve analysis showed that the survival time within 2 years had statistical difference among the patients with different HbA1c levels(P=0.009).The higher the HbA1c level,the shorter the survival time.Conclusion The high HbA1c level has the influence on the stroke recurrence and all-cause mortality within 2 years in the patients with first onset occurrence of AIS.
基金项目
深圳市基础研究面上项目(JCYJ20220530142411026)
维普
万方数据