机构地区:[1]常州市第七人民医院/苏州大学附属常州老年病医院急诊科,江苏常州213000 [2]常州市第七人民医院/苏州大学附属常州老年病医院神经外科,江苏常州213000
出 处:《中国急救复苏与灾害医学杂志》2025年第3期325-328,332,共5页China Journal of Emergency Resuscitation and Disaster Medicine
基 金:江苏省自然科学基金面上项目(BK20201118)。
摘 要:目的探讨急性缺血性脑卒中(AIS)患者取栓后动态糖脂代谢指标与预后情况的关系。方法选择2020年1月—2023年6月在常州市第七人民医院(苏州大学附属常州老年病医院)进行支架取栓的85例AIS患者为本次研究样本,根据患者取栓后3个月内是否发生脑出血、血管再闭塞、死亡等不良事件将其分为预后不良组(n=31)和预后良好组(n=54)。比较两组患者取栓后的血糖波动[平均血糖、平均血糖波动幅度(MAGE)、葡萄糖在范围内时间(TIR)、血糖变异系数]、血脂代谢[甘油三酯、总胆固醇、胆固醇变异系数]。并测定患者取栓后的血液流变学指标、凝血功能指标[D-二聚体(D-D)、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(FIB)]、血栓形成相关因子[血栓素B2(TXB2)、正血小板α-颗粒膜糖蛋白(CD62P)、外周血6酮前列腺素F1α(6-keto-PGF1α)],通过Logistic多因素分析探讨患者糖脂波动情况与预后的关系,Pearson相关性分析探讨糖脂代谢波动与血液流变学、凝血功能、血栓形成相关因子的关系。结果预后不良组患者的平均血糖、MAGE、血糖变异系数、血脂代谢指标、血液流变学指标、D-D、FIB、TXB2、CD62P均高于预后良好组,TIR、TT、PT和6-keto-PGF1α低于预后良好组。多因素分析显示,患者动态糖脂代谢是影响预后的重要因素,且血糖变异系数、胆固醇变异系数均和血液流变学、D-D、FIB、TXB2、CD62P呈正相关,与TT、PT和6-keto-PGF1α呈负相关(P<0.05)。结论AIS患者取栓后的糖脂代谢波动会影响其预后情况。Objective To study on the relationship between dynamic glucolipid metabolism indicators and prognosis in patients with acute ischemic stroke(AIS)after thrombectomy.Methods A total of 85 patients with AIS who underwent stent retrieval from January 2020 to June 2023 in Changzhou Seventh People's Hospital conducted on this study.All patients were divided into a poor prognosis group(n=31)and a good prognosis group(n=54)based on the occurrence of adverse events such as cerebral hemorrhage,vascular re-occlusion,or death within 3 months postthrombectomy.The indicators were tested and compared between two groups including the post-thrombectomy blood sugar fluctuations[average blood sugar,mean amplitude of glycemic excursions(MAGE),Time in Range(TIR),glucose variability coefficient],lipid metabolism indicators[triglycerides,total cholesterol,cholesterol variability coefficient],and hemorheological indicators,coagulation function indicators[D-dimer(D-D),thrombin time(TT),prothrombin time(PT),fibrinogen(FIB)],and thrombosis-related factors[thromboxane B2(TXB2),P-selectin(CD62P),and 6-keto prostaglandin F1α(6-keto-PGF1α)].Logistic multivariate analysis was used to study on the relationship between the patient's glycolipid fluctuation and prognosis,and Pearson correlation analysis to study on the relationship between glycolipid metabolism fluctuation and hemorheology,coagulation function,and thrombosisrelated factors.Results The average blood sugar,MAGE,glucose variability coefficient,lipid metabolism indicators,hemorheological indicators,D-D,FIB,TXB2,CD62P in the poor prognosis group were higher than those in the good prognosis group,while TIR,TT,PT,and 6-keto-PGF1αwere lower.Multivariate analysis showed that dynamic glycolipid metabolism was significant factor for the prognosis.The glucose variability coefficient and cholesterol variability coefficient were positively correlated with hemorheology,D-D,FIB,TXB2,CD62P,and negatively correlated with TT,PT,and 6-keto-PGF1α(P<0.05).Conclusion Fluctuations in glucolipid metabo
关 键 词:急性缺血性脑卒中 支架取栓 糖脂代谢 血液流变学
分 类 号:R743.3[医药卫生—神经病学与精神病学]
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