甘油三酯-葡萄糖指数与豆纹动脉梗死早期神经功能恶化的相关性研究  

Association of triglyceride-glucose index with early neurological deterioration events in patients with acute lenticulostriate infarctions

作　　者：李彩燕 陈名峰 陈培琼 Li Caiyan;Chen Mingfeng;Chen Peiqiong(Department of Neurology,Fuzhou University Affiliated Provincial Hospital,Fujian,Fuzhou 350001,China)

机构地区：[1]福州大学附属省立医院神经内科,福建福州350001

出　　处：《创伤与急诊电子杂志》2024年第4期261-267,共7页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的探讨豆纹动脉梗死(lenticulostriate infarctions,LI)急性期发生早期神经功能恶化(early neurological deterioration,END)的影响因素。方法收集2015年6月1日至2021年12月31日福州大学附属省立医院神经内科发病48h内经颅脑磁共振确诊的89例LI患者的临床资料,根据是否发生END将患者分为END组、非END组。比较分析两组患者的临床、实验室及影像资料。采用单因素分析比较两组患者的基线资料,采用多因素Logistics回归分析确定LI发生END的影响因素。结果89例LI患者中18例发生END(20.2%),71例未发生(79.8%)。单因素分析显示END组就诊时舒张压[94.44(77.00,88.00)mmHg]高于非END组[87.64(77.00,87.50)mmHg],END组的甘油三酯-葡萄糖指数(triglyceride-glucose index,TyGI)(9.00±0.56)高于非END组(8.59±0.55),END组发病时的美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分[3.78(3.00,5.00)分]高于非END组[3.02(1.00,4.00)分],差异均有统计学意义(P<0.05)。进一步进行Logistics回归分析发现,TyGI(OR=7.726,95%CI:1.197~49.870,P=0.032)和发病时的NIHSS评分(OR=2.545,95%CI:1.471~4.405,P=0.001)是LI急性期END发生的危险因素。END组发病后90d的mRS评分[1.58(0.00,3.00)分]较非END组[0.63(0.00,1.00)分]高,差异具有统计学意义(P<0.05)。结论LI急性期患者如果出现高TyGI、高NIHSS评分,则发生END的风险增加,应尽早识别,并积极调整治疗策略。Objective To investigate the influencing factors of early neurological deterioration(END)during the acute phase of lenticulostriate infarctions(LI).Method The clinical data of 89 patients with new LI diagnosed by magnetic resonance imaging(MRI)within 48h of the onset of symptoms at the Depatment of Neurology from June 1,2015 to December 31,2021 were collected.Based on the occurrence of END,all patients were divided into the END group and the non-END group,and the clinical,laboratory data as well as imaging characteristics of the two groups were analyzed.Result There were 18 patients(20.2%)with END involved in the END group,and 71(79.8%)in the non-END group.Univariate analysis showed that the diastolic blood pressure in the END group was higher than that in the non-END group[94.44(77.00,88.00)mmHg v.s.87.64(77.00,87.50)mmHg],the triglyceride-glucose index(TyGI)in the END group was higher than that of the non-END group[(9.00±0.56)v.s.(8.59±0.55)],and the National Institute of Health stroke scale(NIHSS)score at the time of onset in the END group was higher than that in the non-END group[3.78(3.00,5.00)v.s.3.02(1.00,4.00),P<0.05].Logistics regression analysis showed that TyGI(OR=7.726,95%CI:1.197-49.870,P=0.032)and NIHSS score at onset(OR=2.545,95%CI:1.471-4.405,P=0.001)were risk factors for the END of acute phase of LI.The mRS score 90 days after onset in the END group was higher than that in the non-END group[1.58(0.00,3.00)v.s.0.63(0.00,1.00),P<0.05].Conclusion Patients with high TyGI and NIHSS score in acute LI stage are at an increased risk of END,which should be identified as early as possible and treatment strategies should be actively adjusted.

关 键 词：豆纹动脉梗死 早期神经功能恶化 甘油三酯-葡萄糖指数 

分 类 号：R74[医药卫生—神经病学与精神病学]