应激性高血糖比值对缺血性脑卒中预后的预测价值的研究进展

Research progress on the predictive value of stress hyperglycemia ratio in the prognosis of ischemic stroke

急性缺血性卒中(AIS)占我国住院脑血管病的80%以上,具有高发病率、高致死率、高致残率的特点。近半数AIS病人在入院时合并高血糖。在卒中急性期,血糖变化可通过氧化应激和炎症反应、内皮细胞功能障碍等动态机制影响卒中预后。因此,准确识别应激性高血糖具有很重要的意义。随着再灌注治疗的开展,应激性高血糖比值(SHR)作为一种评估应激性高血糖的新型标志物在临床得以重视,且被证实与心肌梗死、AIS等疾病转归密切相关。现从SHR的概述、与AIS预后的关系及卒中后血糖干预进行阐述,旨在更好地认识SHR对卒中病人预后的预测价值,为临床工作提供帮助。

Acute ischemic stroke(AIS)accounts for more than 80%of cerebrovascular diseases hospitalized in China,with the characteristics of high incidence,high mortality and high disability.Nearly half of the patients with AIS were complicated with hyperglycemia on admission.Stroke is a dynamic process in terms of molecular mechanisms.In the acute phase of stroke,the changes of blood glucose can affect the prognosis of stroke through mechanisms such as oxidative stress and inflammation,endothelial cell dysfunction and so on.Therefore,it is of great significance to accurately identify stress hyperglycemia.With the development of reperfusion therapy,stress hyperglycemia ratio(SHR),as a new marker for evaluating stress hyperglycemia,has been paid more and more attention in clinic,and it has been proved to be closely related to the prognosis of myocardial infarction,AIS and other diseases.This article expounds the overview of SHR,the relationship between SHR and the prognosis of AIS,and the intervention of blood glucose after stroke,in order to better understand the predictive value of SHR in the prognosis of patients with stroke and provide help for clinical work.