首页|应激性高血糖比值与急性缺血性脑卒中患者早期神经功能恶化的相关性研究

应激性高血糖比值与急性缺血性脑卒中患者早期神经功能恶化的相关性研究

Correlation between Stress Hyperglycemia Ratio and Early Neurological Deterioration of Patients with Acute Ischemic Stroke

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目的:探讨应激性高血糖比值(SHR)与急性缺血性脑卒中(AIS)患者早期神经功能恶化(END)的关系.方法:连续性收集 2023 年 1 月至 2023 年 6 月就诊于深圳市 3 家三级甲等综合医院的AIS患者临床资料和血液生化指标,根据患者有无发生END将患者分为END组和非END组.采用多因素logistic回归分析SHR是否为AIS患者END的影响因素,采用受试者工作特征(ROC)曲线分析SHR对END的预测价值.结果:共纳入 277 例患者,发生END者48例(17.33%).非END组SHR水平低于END组[0.87(0.15)vs 0.98(0.27),P = 0.001].多因素logistic回归分析显示,与较低SHR组相比,高SHR组患者END发生风险增加[调整后OR = 4.487,95%CI(1.167,20.127),P = 0.030].亚组分析结果显示,在非糖尿病患者组中,以上结果差异具有统计学意义[OR = 4.903,95%CI(1.320,18.206),P = 0.018],而在糖尿病患者组中差异无统计学意义[OR = 0.793,95%CI(0.056,11.242),P = 0.084).SHR预测AIS患者发生END的曲线下面积为0.655[95%CI(0.570,0.740),P = 0.001],SHR的约登指数为 0.275,灵敏度为 72.9%,特异度为 54.6%.结论:HR升高与AIS患者发生END的风险增加有关,可预测AIS患者END的发生.
Objective To investigate the relationship between stress hyperglycemia ratio(SHR)and early neurological deterioration(END)in patients with acute ischemic stroke(AIS).Methods Clinical data and blood biochemical indexes of AIS patients attending three tertiary general hospitals in Shenzhen City from January 2023 to June 2023 were collected consecutively,and patients were divided into END and non-END groups according to the presence or absence of END.Multifactorial logistic regression was used to analyze whether influencing stress hyperglycemia ratio was a influence factor for END in AIS patients,and the predictive value of SHR for END was analyzed by using receiver operating characteristic(ROC)curve.Results A total of 277 patients were included,and 48(17.33%)had END.The SHR level was lower in the non-END group than that in the END group[0.87(0.15)vs 0.98(0.27),P = 0.001].Multifactorial logistic regression analysis showed that patients in the high SHR group had an increased risk of END compared to the lower SHR group[adjusted OR = 4.487,95%CI(1.167,20.127),P = 0.030].Subgroup analysis showed that the difference between the above results was statistically significant in the non-diabetic group[OR = 4.903,95%CI(1.320,18.206),P = 0.018],whereas the difference was not statistically significant in the diabetic group[OR = 0.793,95%CI(0.056,11.242),P = 0.084].SHR predicted the END in patients with ischemic stroke had an area under the curve of 0.655[95%CI(0.570,0.740),P = 0.001],and Youden index for SHR was 0.275,with a sensitivity of 72.9%and a specificity of 54.6%.Conclusion Elevated HR is associated with an increased risk of END in patients with AIS and could predict the occurrence of END in patients with AIS.

Stress hyperglycemia ratioIschemic strokeEarly neurological deteriorationInfluence factor

肖仕艳、高茂凤、胡守娣、滕丽婷、曹思敏、谢小华

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南华大学护理学院,湖南 衡阳 421001

安徽医科大学护理学院,安徽 合肥 230032

广西中医药大学护理学院,广西 南宁 530001

广州医科大学护理学院,广东 广州 511436

深圳市第二人民医院,广东 深圳 518035

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应激性高血糖比值 缺血性脑卒中 早期神经功能恶化 影响因素

深圳市科创委科技"自由探索"项目深圳市高水平医院建设项目深圳市第二人民医院临床研究项目

JCYJ2018022816302699520223357018

2024

深圳中西医结合杂志
深圳市中西医结合临床研究所

深圳中西医结合杂志

影响因子:0.692
ISSN:1007-0893
年,卷(期):2024.34(2)
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