血糖变异性对急性脑梗死患者rt-PA溶栓治疗后血管再闭塞的预测价值  

Predictive Value of Blood Glucose Variability on Vascular Re-occlusion in Patients with Acute Cerebral Infarction After rt-PA Thrombolytic Therapy

作　　者：董万亮 DONG Wanliang(Department of Neurology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院神经内科,河南郑州450000

出　　处：《河南医学研究》2023年第15期2718-2721,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200394)。

摘　　要：目的探讨血糖变异性对于急性脑梗死患者应用阿替普酶(rt-PA)溶栓治疗后发生血管再闭塞的预测价值。方法采用回顾性研究,收集2020年1月至2022年8月于郑州大学第二附属医院接受rt-PA溶栓治疗的92例急性脑梗死患者病历资料,所有患者治疗后均接受3个月门诊随访,依据治疗后3个月内血管再闭塞发生情况分为再闭塞组(n=22)与未闭塞组(n=70)。由研究者设计一般资料调查表,收集患者一般资料及入院后48 h内血糖指标,计算可反映血糖变异性的数据[血糖最大波动幅度(LAGE)、血糖值标准差(SDBG)、平均血糖波动幅度(MAGE)、血糖变异系数(CV)],并进行对比;采用点二列相关性分析LAGE、SDBG、MAGE、CV与rt-PA溶栓治疗后血管再闭塞发生的相关性,绘制受试者工作特征(ROC)曲线评估LAGE、SDBG、MAGE、CV单独及联合预测急性脑梗死患者rt-PA溶栓治疗后血管再闭塞发生的价值。结果再闭塞组LAGE、SDBG、MAGE、CV水平均高于未闭塞组,差异具有统计学意义(P<0.05);经点二列相关性分析显示,LAGE、SDBG、MAGE、CV水平与急性脑梗死患者rt-PA溶栓治疗后血管再闭塞发生呈正相关(r>0,P<0.05);绘制ROC曲线,结果显示,LAGE、SDBG、MAGE、CV水平预测急性脑梗死患者rt-PA溶栓治疗后血管再闭塞发生的曲线下面积(AUC)>0.7,具有一定的预测价值,且联合预测价值更高。结论血糖变异性能够预测急性脑梗死患者rt-PA溶栓治疗后血管再闭塞发生风险,且应用LAGE、SDBG、MAGE、CV水平进行联合预测的价值更高。Objective To explore the predictive value of blood glucose variability in the occurrence of vascular re-occlusion in patients with acute cerebral infarction after alteplase thrombolysis(rt-PA)therapy.Methods A retrospective study was conducted to collect the medical records of 92 patients with acute cerebral infarction who received rt-PA thrombolytic therapy in the Second Affiliated Hospital of Zhengzhou University from January 2020 to August 2022.All patients were followed up for 3 months after treatment.They were divided into reocclusion group(n=22)and non-occlusion group(n=70)according to the occurrence of vascular re-occlusion within 3 months after treatment.The general data questionnaire was designed by the researcher to collect the general data of the patients and the blood glucose index within 48 hours after admission.The data that can reflect the blood glucose variability[largest amplitude of glycemic excursion(LAGE),the standard deviation of blood glucose(SDBG),mean amplitude of glycemic excursions(MAGE),the coefficient of variation(CV)of blood glucose]were calculated and compared.The correlation between LAGE,SDBG,MAGE,CV and the occurrence of vascular re-occlusion after rt-PA thrombolytic therapy was analyzed by point-by-column correlation,and the value of LAGE,SDBG,MAGE,CV alone and in combination to predict the occurrence of vascular re-occlusion after rt-PA thrombolytic therapy in patients with acute cerebral infarction was evaluated by drawing the receiver operating characteristic(ROC)curve of subjects.Results The levels of LAGE,SDBG,MAGE and CV in reocclusion group were higher than those in non-occlusion group,with a statistical significant difference(P<0.05).The point binary correlation analysis showed that the levels of LAGE,SDBG,MAGE and CV were positively correlated with the occurrence of vascular re-occlusion in patients with acute cerebral infarction after rt-PA thrombolytic therapy(r>0,P<0.05).The ROC curve was drawn.The results showed that the area under the curve(AUC)of LAGE,SDBG,MAGE and

关 键 词：急性脑梗死 阿替普酶溶栓 血管再闭塞 血糖变异性 预测 

分 类 号：R743.3[医药卫生—神经病学与精神病学]