血糖间隙对药物保守治疗脑卒中患者症状性颅内出血的预测价值

Prediction Value of Glycemic Gap for Symptomatic Intracranial Hemorrhage inPatients with Stroke Treated with Conservative Medicine

目的 探讨血糖间隙对药物保守治疗脑卒中患者症状性颅内出血的预测价值。方法 选取2021年1月—2023年1月在首都医科大学宣武医院接受药物保守治疗的133例老年脑卒中患者进行回顾性分析,按照是否发生症状性颅内出血分为发生组(33例)和未发生组(100例),收集两组临床相关资料,使用多因素logistic回归分析影响症状性颅内出血发生的相关因素,并绘制ROC曲线分析血糖间隙对症状性颅内出血发生的预测价值。结果 两组的年龄、饮酒史、美国国立卫生研究院卒中量表(NIHSS)评分、合并高血压及血糖间隙比较,差异均有统计学意义(P<0.05);以有差异的指标作为自变量代入logistic回归方程,结果显示:年龄≥75岁、饮酒史、NIHSS评分、伴有高血压、血糖间隙均为接受药物保守治疗的脑卒中患者症状性颅内出血发生的独立危险因素(P<0.05);ROC曲线显示,血糖间隙对脑卒中患者症状性颅内出血发生具有较高的预测价值(曲线下面积为0.898)。结论 血糖间隙是脑卒中患者症状性颅内出血发生的影响因素,对脑卒中患者症状性颅内出血具有较高的预测价值。

Objective To investigate the predictive value of glycemic gap in the conservative medicine treatment of symptomatic intracranial hemorrhage in stroke patients.Methods A retrospective analysis was conducted on 133 elderly stroke patients who received conservative drug treatment in Xuanwu Hospital,Capital Medical University from January 2021 to January 2023.According to whether symptomatic intracranial hemorrhage occurred,they were divided into the occurrence group(33 cases)and the non-occurrence group(100 cases),and relevant clinical data of the two groups were collected.Multivariate logistic regression was used to analyze the related factors affecting the occurrence of symptomatic intracranial hemorrhage,and ROC curve was drawn to analyze the predictive value of glycemic gap on the occurrence of symptomatic intracranial hemorrhage.Results There were significant differences in age,drinking history,National Institutes of Health Stroke Scale(NIHSS)score,combined hypertension and glycemic gap between the two groups(P<0.05).Indicators with differences were substituted into logistic regression equations as independent variables,the results showed that age≥75 years old,drinking history,NIHSS score,accompanied by hypertension and glycemic gap were all independent risk factors for symptomatic intracranial hemorrhage in stroke patients receiving conservative drug treatment(P<0.05).ROC curve showed that the glycemic gap had a high predictive value for symptomatic intracranial hemorrhage in stroke patients(area under the curve was 0.898).Conclusion Glycemic gap is an influential factor for symptomatic intracranial hemorrhage in stroke patients,and has a high predictive value for symptomatic intracranial hemorrhage in stroke patients.