糖化血红蛋白与急性脑桥梗死患者预后的关系

Relationship between glycosylated haemoglobin and prognosis of patients with acute pontine infarction

目的探讨糖化血红蛋白(HbA1c)与急性脑桥梗死患者预后的关系。方法分析2016年5月—2018年4月合肥市第八人民医院神经内科的85例急性脑桥梗死患者既往糖尿病史、入院后空腹血糖、HbA1c等因素与患者90 d随访时的改良Rankin评分(mRS)、日常生活自理能力(ADL)评分的关系。结果HbA1c与脑桥梗死患者90 d预后良好(mRS<3分)相关(OR=0.234,95%CI:0.073~0.784,P=0.014);HbA1c≥6.1%(OR=0.404,95%CI:0.138~1.188,P=0.100)、糖尿病史(OR=0.556,95%CI:0.197~1.565,P=0.266)、空腹血糖≥7.0 mmol/L(OR=0.516,95%CI:0.179~1.488,P=0.221)与患者90 d随访时日常生活自理能力(ADL>60分)不相关。HbA1c相比较糖尿病史及空腹血糖具有更高的AUC值(mRS<3分,AUC=0.725,95%CI:0.615~0.835,P=0.001;ADL>60分,AUC=0.682,95%CI:0.556~0.808,P=0.016)。结论相比于糖尿病史及空腹血糖等因素,HbA1c在评价急性脑桥梗死患者预后方面可能更具有优势。

Objective To investigate the relationship between glycosylated haemoglobin(HbA1 c)and prognosis of patients with acute pontine infarction.Methods The relationship between the history of diabetes,fasting blood glucose and HbA1 c after admission,and the scores of modified Rankin score(mRS)and daily life self-care ability(ADL)at 90 d follow-up in 85 patients with acute pontine infarction in Hefei Eighth People’s Hospital from May 2016 to April-2018 were analysed.Results A significant correlation between HbA1 c and prognosis(mRS<3)was observed in patients with pontine infarction at 90-day follow-up(OR=0.234,95%CI:0.073-0.784,P=0.014).In addition,no significant correlation amongst HbA1 c≥6.1%(OR=0.404,95%CI:0.138-1.188,P=0.100),history of diabetes(OR=0.556,95%CI:0.197-1.565,P=0.266),fasting blood glucose≥7.0 mmol/L(OR=0.516,95%CI:0.179-1.488,P=0.221)and ADL>60 was observed in patients at 90-day follow-up.HbA1 c had higher AUC value(mRS<3,AUC=0.725,95%CI:0.615-0.835,P=0.001;ADL>60,AUC=0.682,95%CI:0.556-0.808,P=0.016)than diabetes history and fasting blood glucose.Conclusion Compared with fasting blood glucose and diabetes history,glycosylated haemoglobin may have an advantage in evaluating the prognosis of patients with acute pontine infarction.