TyG指数在缺血性脑卒中梗死面积评估中的作用

The role of TyG index in assessment of infarct area in ischemic stroke

目的已有研究表明,甘油三酯/葡萄糖(TyG)指数反映了胰岛素抵抗并预测缺血性中风(ischemic stroke,IS)的风险。大面积脑梗死作为缺血性脑卒中预后较差的一种类型,更容易产生并发症、后遗症,但目前研究中还未有研究探索TyG指数与大面积脑梗死(MCI)的关系。本研究旨在探讨TyG指数在缺血性脑卒中梗死面积评估中的作用。方法这项回顾性研究纳入了2020年1月—2024年6月在本院内经头颅磁共振成像(MRI)确诊收治的212例成人缺血性脑卒中患者。按研究目的分为大面积脑梗死组、非大面积脑梗死组,使用SPSS 26.0软件对各组进行单因素和多因素logistic回归分析,对预测模型进行受试者工作特性(ROC)曲线分析。结果通过纳入单因素logistic回归分析中P<0.2的变量进行多因素logistic回归分析,结果显示年龄(OR 1.043,95%CI 1.004~1.084,P<0.05)、NIHSS评分(OR 22.986,95%CI 8.679~60.882,P<0.001)、TyG指数(OR 1.729,95%CI 1.017~2.941,P<0.05)。预测模型的ROC曲线下面积(AUC)是0.868(P<0.001),预测效能较好。结论TyG指数是大面积脑梗死的独立危险因素,且TyG指数结合临床检验指标可以较好地预测大面积脑梗死。

Objective Previous studies have shown that the triglyceride-glucose(TyG)index reflects insulin resistance and predicts the risk of ischemic stroke.Massive cerebral infarction,as a type of ischemic stroke with poor prognosis,is of-ten more prone to complications and sequelae.However,no studies have yet explored the relationship between the TyG in-dex and massive cerebral infarction.This study aims to investigate the role of the TyG index in assessing the infarct area in ischemic stroke.Methods This retrospective study included 212 adult patients with ischemic stroke diagnosed by cranial magnetic resonance imaging and admitted to our hospital from January 2020 to June 2024.The patients were divided into massive cerebral infarction group and non-massive cerebral infarction group according to the study purpose.Univariable and multivariable logistic regression analyses were performed on each group using SPSS 26 software.The receiver operating characteristic curves were analyzed for the prediction models.Results Variables with P<0.2 in the univariable logistic re-gression analysis were included in the multivariable logistic regression analysis.The results showed that age(OR 1.043,95%CI 1.004-1.084,P<0.05),National Institutes of Health Stroke Scale score(OR 22.986,95%CI 8.679-60.882,P<0.001),and TyG index(OR 1.729,95%CI 1.017-2.941,P<0.05)were significant predictors.The area under the receiver operating characteristic curve of the predictive model was 0.868(P<0.001),indicating high predictive performance.Conclusion The TyG index is an independent risk factor for massive cerebral infarction.The combination of the TyG in-dex with clinical laboratory indicators can effectively predict massive cerebral infarction.