三酰甘油-葡萄糖指数对急性缺血性脑卒中合并代谢综合征患者短期预后的影响

Impact of Triglyceride-Glucose Index on Short-Term Prognosis of Acute Ischemic Stroke Patients with Metabolic Syndrome

目的探讨三酰甘油-葡萄糖(TyG)指数对急性缺血性脑卒中(AIS)合并代谢综合征(MS)患者短期预后的影响。方法连续性选取2020年1月至2021年5月在合肥市第一人民医院西区内分泌科就诊的143例AIS合并MS患者为研究对象,其中9例患者失访,最终纳入134例患者。根据TyG指数的中位数将所有患者分为高TyG指数组(TyG指数≥8.90,n=67)和低TyG指数组(TyG指数<8.90,n=67)。比较两组临床资料,绘制生存曲线以分析两组预后不良及复发或全因死亡情况。绘制ROC曲线以评价TyG指数对AIS合并MS患者预后的预测价值。结果高TyG指数组体质指数、收缩压、舒张压高于低TyG指数组(P<0.05)。生存曲线分析结果显示,低TyG指数组随访3个月、1年预后良好发生率为94.0%、91.0%,分别高于高TyG指数组的80.6%、71.6%(P<0.05);随访1年低TyG指数组无脑卒中复发且无全因死亡发生率高于高TyG指数组(P<0.05)。多元Cox回归分析结果显示,TyG指数是AIS合并MS患者随访3个月、1年预后不良及随访1年脑卒中复发或全因死亡的独立影响因素(P<0.05)。ROC曲线分析结果显示,TyG指数预测AIS合并MS患者随访3个月、1年预后不良及随访1年脑卒中复发或全因死亡的AUC分别为0.896〔95%CI(0.840,0.952)〕、0.870〔95%CI(0.805,0.936)〕、0.852〔95%CI(0.783,0.922)〕。结论TyG指数是AIS合并MS患者随访3个月、1年预后不良及随访1年脑卒中复发或全因死亡的独立影响因素,其对患者随访3个月、1年预后不良及随访1年脑卒中复发或全因死亡具有一定预测价值。

Objective To investigate the impact of triglyceride-glucose(TyG)index on short-term prognosis of acute ischemic stroke(AIS)patients with metabolic syndrome(MS).Methods From January 2020 to May 2021,143 AIS patients with MS who were treated in the Department of Endocrinology,West District of Hefei First People's Hospital were continuously selected as the research objects,of which 9 patients were lost to follow-up,and 134 patients were finally included.The patients were divided into high TyG index group(TyG index≥8.90,n=67)and low TyG index group(TyG index<8.90,n=67)according to the median of TyG index.The clinical data of the two groups were compared,and the survival curve was drawn to analyze the poor prognosis and recurrence or all-cause death.ROC curve was drawn to evaluate the value of TyG index in predicting prognosis of AIS patients with MS.Results Body mass index,systolic blood pressure and diastolic blood pressure in high TyG index group were higher than those in low TyG index group(P<0.05).Survival curve analysis results showed that the incidence of good prognosis at 3 months and 1 year of follow-up in the low TyG index group was 94.0%and 91.0%,respectively,which were higher than 80.6%and 71.6%in the high TyG index group(P<0.05).The incidence of no recurrence of stroke and no all-cause death in the low TyG index group was higher than that in the high TyG index group(P<0.05).Multivariate Cox regression analysis showed that TyG index was an independent influencing factor for poor prognosis at 3 months and 1 year of follow-up and stroke recurrence or all-cause death at 1 year of follow-up in AIS patients with MS (P < 0.05) . ROC curve analysis showed that the AUC of TyG index in predicting poor prognosis at 3 months and 1 year of follow-up and stroke recurrence or all-cause death at 1 year of follow-up were 0.896 [95%CI (0.840, 0.952) ] , 0.870 [95%CI (0.805, 0.936) ] and 0.852 [95%CI (0.783, 0.922) ] , respectively. Conclusion The TyG index is an independent influencing factor of poor prognosis in AIS patients with MS at 3 months and 1 year of follow-up and stroke recurrence or all-cause death at 1 year of follow-up. It has certain predictive value for poor prognosis at 3 months and 1 year follow-up and stroke recurrence or all-cause death at 1 year of follow-up.