糖化血红蛋白在2型糖尿病合并脑卒中后肺炎中的临床价值

Clinical value of glycosylated hemoglobin in type 2 diabetes mellitus complicated with post-stroke pneumonia

目的探讨糖化血红蛋白(HbA_(1c))在2型糖尿病(T2DM)合并脑卒中后肺炎中的临床价值。方法选取2019年12月至2021年12月江苏省如皋市人民医院(以下简称“我院”)收治的120例T2DM合并脑卒中后肺炎患者作为研究组,另选取同期我院收治的112例T2DM合并脑卒中后未发生肺炎患者作为对照组。比较两组临床特征,分析影响T2DM合并脑卒中后发生肺炎的影响因素,并进一步采用受试者操作特征(ROC)曲线分析血清HbA_(1c)水平预测T2DM合并脑卒中后发生肺炎的价值。结果研究组意识障碍占比、美国国立卫生研究院卒中量表评分、C反应蛋白、降钙素原、空腹血糖、白细胞计数、HbA_(1c)水平与对照组比较,差异均有统计学意义(P<0.05)。多因素分析结果显示,HbA_(1c)水平(OR=3.177,95%CI:1.143~8.828)、意识障碍情况(OR=2.971,95%CI:1.587~5.564)均为T2DM合并脑卒中后发生肺炎的独立影响因素(P<0.05)。ROC曲线结果显示,血清HbA_(1c)水平预测T2DM合并脑卒中后发生肺炎的截断值为7.83%,灵敏度为84.17%,特异度为95.54%,曲线下面积为0.930(P<0.05)。结论T2DM合并脑卒中后发生肺炎患者血清HbA_(1c)水平异常升高,且HbA_(1c)水平是T2DM合并脑卒中后发生肺炎的独立影响因素,动态监测其水平变化在预测T2DM合并脑卒中患者肺炎发生中具有重要价值。

Objective To explore the clinical value of glycosylated hemoglobin(HbA_(1c))in type 2 diabetes mellitus(T2DM)complicated with post-stroke pneumonia.Methods A total of 120 patients with T2DM complicated with post-stroke pneumonia admitted to Rugao People’s Hospital(hereinafter referred to as“our hospital”)of Jiangsu Province from December 2019 to December 2021 were selected as the study group,and 112 patients with T2DM complicated with stroke and no pneumonia admitted to our hospital during the same period were selected as the control group.The clinical features of the two groups were compared,and the factors affecting the incidence of T2DM complicated with post-stroke pneumonia were analyzed,the value of serum HbA_(1c)level in predicting the incidence of T2DM complicated with post-stroke pneumonia was further analyzed by receiver operating characteristic(ROC)curve.Results There were significant differences in the proportion of consciousness disorder,National Institutes of Health stroke scale score,C-reactive protein,procalcitonin,fasting blood glucose,white blood cell count,and HbA_(1c)level between the study group and the control group(P<0.05).The results of multivariate analysis showed that HbA_(1c)level(OR=3.177,95%CI:1.143-8.828)and disorder of consciousness(OR=2.971,95%CI:1.587-5.564)were independent factors for the occurrence of T2DM complicated with post-stroke pneumonia(P<0.05).ROC curve results showed that the cut-off value was 7.83%,sensitivity was 84.17%,specificity was 95.54%,and area under the curve was 0.930 for serum HbA_(1c)level to predict T2DM complicated with post-stroke pneumonia(P<0.05).Conclusion Serum HbA_(1c)level is abnormally elevated in patients with T2DM complicated with post-stroke pneumonia,and HbA_(1c)level is an independent influencing factor of T2DM complicated post-stroke pneumonia.Dynamic monitoring of Hba1c level is of great value in predicting the occurrence of T2DM complicated with post-stroke pneumonia.