急性脑梗死患者血糖波动与NIHSS评分、mRS评分及血清炎症因子水平的相关性研究  

Correlation between blood glucose fluctuation and NIHSS score,mRS score and serum inflammatory factor level in patients with acute cerebral infarction

作　　者：车静[1] 蔡耘[1] 刘娜 李伟彬[1] 邸卫英[1] Che Jing;Cai Yun;Liu Na;Li Weibin;Di Weiying(Department of Neurology,Affiliated Hospital of Hebei University,Baoding,Hebei,071000,P.R.China)

机构地区：[1]河北大学附属医院神经内科,河北保定071000

出　　处：《老年医学与保健》2022年第1期92-97,共6页Geriatrics & Health Care

基　　金：河北省2019政府资助临床医学优秀人才培养项目计划[冀财社(2019)139号]。

摘　　要：目的研究急性脑梗死患者血糖波动与血清炎症因子水平、美国国立卫生院研究卒中表(NIHSS)评分和改良Rankin量表(mRS)评分的相关性。方法将河北大学附属医院神经内科2019年2月—2021年2月间收治的97例急性脑梗死患者纳入观察组,同时将60例健康体检合格者纳入对照组,比较2组血糖波动参数及血清炎症因子,比较不同NIHSS评分患者日内平均血糖波动幅度(MAGE)和全天血糖水平标准差(SDBG),比较不同mRS评分患者MAGE、SDBG值及炎症因子水平,比较MAGE增高组和MAGE正常组患者NIHSS评分、mRS评分及血清炎症因子水平,采用Pearson检验和Spearman检验进行相关性分析,采用受试者工作曲线(ROC)评价各指标对急性脑梗死预后不良的预测效能。结果观察组MAGE、SDBG及血清白介素6 (IL-6)、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hs-CRP)水平均显著高于对照组(P<0.05);不同NIHSS评分患者MAGE和SDBG值差异有统计学意义(P<0.05);mRS评分> 2分患者MAGE、SDBG值及TNF-α、IL-6、hs-CRP水平均显著高于≤2分患者(P<0.05);MAGE增高组患者NIHSS评分、mRS评分及TNF-α、IL-6、hs-CRP水平均显著高于MAGE正常组患者(P<0.05)。相关性分析提示,急性脑梗死患者的MAGE、SDBG值与TNF-α、IL-6、hs-CRP、NIHSS评分、mRS评分均呈正相关(P<0.05);绘制ROC曲线发现,血糖波动参数联合炎症因子预测急性脑梗死预后不良具有较高的预测效能(AUC=0.866、灵敏度90.02%、特异度73.08%)。结论急性脑梗死患者血糖波动性与患者NIHSS评分、mRS评分及血清炎症因子水平显著相关,提示监测血糖波动情况有助于评估急性脑梗死病情及预后。Objective To study the correlation between blood glucose fluctuation and NIHSS score,Modified Rankin Scale(mRS)score and serum inflammatory factor level in patients with acute cerebral infarction. Methods 97 patients with acute cerebral infarction treated in the Department of Neurology of the Affiliated Hospital of Hebei University from February2019 to February2021 were included in the observation group,and60 healthy people who passed the physical examination were included in the control group. The blood glucose fluctuation parameters and levels of serum inflammatory factors were compared between the two groups,and the daily mean blood glucose fluctuation range(MAGE)and the standard deviation of whole day blood glucose level(SDBG)of the patients with different NIHSS scores were compared,MAGE,SDBG and levels of serum inflammatory factors in the patients with different mRS scores were compared. NIHSS score,mRS score and levels of serum inflammatory factors were compared between patients with increased MAGE and patients with normal MAGE. Pearson test and Spearman test were used for correlation analysis,and receiver operating curve(ROC)was used to evaluate the predictive efficacy of each index on the poor prognosis of acute cerebral infarction. Results MAGE,SDBG and the levels of serum interleukin6(IL-6),tumor necrosis factorα (TNF-α)and high-sensitivity C-reactive protein(hs-CRP)of the observation group were significantly higher than those of the control group(P< 0.05). There were signifi-cant differences in MAGE and SDBG among patients with different NIHSS scores(P< 0.05). MAGE,SDBG and levels of TNF-α,IL-6,hs-CRP in patients with mRS score> 2 were significantly higher than those in patients with mRS score≤ 2(P< 0. 05);NIHSS score,mRS score and levels of TNF-α,IL-6 and hs-CRP in the increased AGE group were significantly higher than those in the normal MAGE group(P< 0.05). Correlation analysis showed that MAGE and SDBG values in patients with acute cerebral infarction were positively correlated with NIHSS sco

关 键 词：老年 急性脑梗死 血糖波动 炎症因子 NIHSS评分 改良Rankin量表 相关性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]