目的 探讨急性脑出血患者血糖水平和血糖波动情况与短期预后的关系.方法 回顾性分析2020-01至2022-12期间在本院急诊重症监护室(emergency intensive care unit,EICU)收治的急性脑出血病例资料,根据28 d生存情况分为存活组和死亡组,比较两组一般资料、静脉血糖资料、脑出血相关评分资料的差异,用多因素Logistic回归分析,得到独立的危险因素,以ROC曲线验证其预测意义.结果 多因素Logistic回归分析结果提示颅内出血量不少于30mL、入院时的GCS评分、入院时收缩压以及最大血糖波动幅度,均与脑出血病例在28 d内的病死率相关.最大血糖波动幅度与28 d内死亡关系建立ROC曲线,曲线下面积(AUC=0.711,P＜0.01).结论 最大血糖波动幅度(largest amplitude of glucose excursion,LAGE)是急性脑出血短期死亡的独立危险因子,对于脑出血预后有预测价值.
Correlation between largest amplitude of glycemic excursionand short-term prognosis in patients with acute intracerebral hemorrhage
Objective To explore the relationship between blood glucose levels and blood glucose fluctuations and short-term prognosis in patients with acute cerebral hemorrhage.Methods A retrospective analysis was conducted on the medical records of patients with acute cerebral hemorrhage admitted to our hospital's Emergency Intensive Care Unit(EICU)from January 2020 to December 2022.Patients were divided into the survival group and death group based on their 28-day survival status.Differences in general information,intravenous blood glucose data,and cerebral hemorrhage-related scoring data between the two groups were compared.Multivariate logistic regression analysis was used to identify independent risk factors,and the predictive significance was verified using the ROC curve.Results The results of the multivariate logistic regression analysis indicated that intracranial hemorrhage volume of no less than 30 mL,GCS score at admission,systolic blood pressure at admission,and the maximum amplitude of blood glucose fluctuations were correlated with the mortality rate of cerebral hemorrhage cases within 28 days.The relationship between the maximum amplitude of blood glucose fluctuations and death within 28 days was established using the ROC curve,with an area under the curve(AUC)of 0.711(P＜0.01).Conclusions The largest amplitude of glucose excursion(LAGE)is an independent risk factor for short-term death and has predictive value for the prognosis in patients with ICH.
Acute intracranial hemorrhageLargest amplitude of glycemic excursionBlood glucose variabilityPrognosis
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