急性脑梗死患者应激性高血糖与胱抑素-C水平及预后的关系

The relationship between stress hyperglycemia and cystatin-C level and prognosis in patients with acute cerebral infarction

目的探讨急性脑梗死(ACI)患者应激性高血糖与胱抑素-C(Cys-C)水平及预后的关系。方法选取2016年6月至2020年12月铜川矿务局中心医院神经内科收治的180例ACI患者作为研究对象,根据空腹血糖(FPG)水平是否>7.0 mmol/L将其分为对照组(123例)和高血糖组(57例)。比较两组的临床资料,分析ACI患者发生应激性高血糖的危险因素及Cys-C对ACI患者发生应激性高血糖的预测价值,比较不同预后ACI患者的FPG水平,分析ACI患者FPG与预后的相关性。结果高血糖组的高血脂、房颤发生率、超敏C反应蛋白(hs-CRP)、Cys-C水平高于对照组(P<0.05)。二元Logistic回归分析结果显示,高血脂、房颤、hs-CRP、Cys-C均为ACI患者发生应激性高血糖的独立危险因素(P<0.05)。Cys-C预测ACI患者发生应激性高血糖的受试者工作特征(ROC)曲线下面积(AUC)为0.902,灵敏度为85.96%,特异度为92.68%。预后不良ACI患者的FPG水平高于预后良好ACI患者(P<0.05)。Spearman相关性检验结果显示,ACI患者的FPG水平与预后呈负相关(r=-0.775,P<0.05)。结论Cys-C对ACI患者发生应激性高血糖具有较高的预测价值,ACI患者的FPG水平与预后呈负相关。

Objective To explore the relationship between stress hyperglycemia and cystatin-C(Cys-C)level and prognosis in patients with acute cerebral infarction(ACI).Methods A total of 180 ACI patients admitted in the neurology department of Tongchuan Mining Bureau Central Hospital from June 2016 to December 2020 were selected as the research objects.According to whether the fasting plasma glucose(FPG)level was>7.0 mmol/L,the patients were divided into control group(123 cases)and hyperglycemia group(57 cases).The clinical data of the two groups were compared.The risk factors of stress hyperglycemia in ACI patients and the predictive value of Cys-C for stress hyperglycemia in ACI patients were analyzed.The FPG level of ACI patients with different prognosis was compared,and the correlation between FPG and prognosis in ACI patients was analyzed.Results The incidences of hyperlipidemia,atrial fibrillation,high sensitive C-reactive protein(hs-CRP)and Cys-C levels in the hyperglycemia group were higher than those in the control group(P<0.05).Binary Logistic regression analysis showed that hyperlipidemia,atrial fibrillation,hs-CRP and Cys-C were independent risk factors for stress hyperglycemia in ACI patients(P<0.05).The areas under curve(AUC)of receiver operating characteristic(ROC)of Cys-C predicting stress hyperglycemia in ACI patients was 0.902,the sensitivity was 85.96%,and the specificity was 92.68%.The FPG level of ACI patients with poor prognosis was higher than that with good prognosis(P<0.05).Spearman correlation test showed that the FPG level in ACI patients was negatively correlated with prognosis(r=-0.775,P<0.05).Conclusion Cys-C has a high predictive value for stress hyperglycemia in ACI patients,and FPG level in ACI patients is negatively correlated with prognosis.