糖尿病前期与急性脑梗死患者不良预后的相关性研究

Association between prediabetes and poor outcome of acute ischemic stroke

目的研究急性脑梗死患者中糖尿病前期与不良预后相关性。方法回顾性纳入河南科技大学第一附属医院神经内科2018年9月-12月期间住院的初发急性脑梗死患者,根据不同糖化血红蛋白水平分为:糖尿病前期组、糖尿病组、非糖尿病组。观察患者的相关信息,并于出院后90 d电话随访1次。并依据改良Rankin评分,将患者预后分为预后良好组和预后不良组。结果共纳入患者188例,最终纳入160例。其中,非糖尿病组66例,糖尿病前期组39例,糖尿病组55例;预后不良组68例,预后良好组92例。非糖尿病组、糖尿病前期组、糖尿病组组间除高脂血症(χ^2=7.781,P=0.020)、三酰甘油(triglyceride,TG)(F=8.220,P<0.001)、入院血糖(F=44.356,P<0.001)外,其余基本情况比较,差异均无统计学意义(P>0.05)。预后不良组与预后良好组组间除高脂血症(χ^2=4.847,P=0.028)、入院血糖(t=-2.940,P=0.004)、TG(t=-2.766,P=0.006)、NIHSS评分(Z=-6.038,P<0.001)外,其余指标比较,差异均无统计学意义(P>0.05)。糖尿病前期组[比值比(odds ratio,OR)=4.053,95%置信区间(confidence interval,CI)(1.491,11.019)]和糖尿病组[OR=5.986,95%CI(2.330,15.379)]患者3个月后预后不良。结论在初发急性脑梗死患者中,糖尿病前期和糖尿病与急性脑梗死患者3个月后不良预后相关。

Objective To explore the association between prediabetes and poor outcome in patients with acute ischemic stroke(AIS).Methods The patients with first-ever AIS who were hospitalized in the Department of Neurology,the First Affiliated Hospital of Henan University of Science and Technology from September to December 2018 were retrospectively enrolled.According to the different levels of hemoglobin A1c,the patients were divided into prediabetes group,diabetes mellitus(DM)group and non-DM group.The outcome of the patients 3 months after the discharge was assessed by the modified Rankin Scale and dichotomized as good and poor outcomes.Results A total of 188 patients were included,and 160 were eventually included.Among them,66 cases were in the non-DM group,39 were in the prediabetes group,and 55 were in the DM group;68 patients were in the poor prognosis group and 92 were in the good prognosis group.There was no statistically significant difference among the non-DM group,prediabetes group,and DM group(P>0.05)except for hyperlipidemia(χ^2=7.781,P=0.020),triglyceride(TG)(F=8.220,P<0.001)and admission blood glucose(F=44.356,P<0.001).There was no statistically significant difference between the good prognosis group and the poor prognosis group(P>0.05)except for hyperlipidemia(χ^2=4.847,P=0.028),admission blood glucose(t=−2.940,P=0.004),TG(t=−2.766,P=0.006),and NIHSS(Z=−6.038,P<0.001).Prediabetic[odds ratio(OR)=4.053,95%confidence interval(CI)(1.491,11.019)]and diabetic[OR=5.986,95%CI(2.330,15.379)]patients had a worse prognosis 3 months after the discharge.Conclusion In adults with first-ever AIS,prediabetes and diabetes were associated with poor prognosis in patients with AIS after 3 months.