急性缺血性脑卒中静脉溶栓患者血糖及糖化血红蛋白与预后相关性的研究进展

Research Progress of Correlation between Blood Glucose and Glycosylated Hemoglobin and Prognosis of AIS Intravenous Thrombolysis

急性缺血性脑卒中(AIS)是指脑血供突然中断后导致的脑组织坏死,而出现相应神经功能缺损的一类临床综合征。静脉溶栓治疗超早期急性缺血性脑卒中是目前普遍认可的有效治疗方案。大量研究已证实糖尿病是急性缺血性卒中的独立危险因素。有研究证明无论是糖尿病造成的高血糖还是应激性高血糖或者糖化血红蛋白、血糖变异性的升高都是AIS患者静脉溶栓后早期神经功能恶化、出血转化、不良预后的独立预测因素。本文就血糖及糖化血红蛋白与AIS静脉溶栓患者预后、早期神经功能恶化和SICH的关系以及可能机制进行综述。

Acute ischemic stroke (AIS) is a clinical syndrome that cerebral tissue is necrotic due to sudden interruption of cerebral blood supply, resulting in neurological deficits. At present, intravenous thrombolysis is an effective treatment in ultra-early acute ischemic stroke. A large number of studies have confirmed that diabetes is an independent risk factor of acute ischemic stroke. Some studies have shown that hyperglycemia caused by diabetes, stress hyperglycemia, increasing glycosylated hemoglobin, and glucose variability are independent predictors of early neurological deterioration, hemorrhagic transformation and poor prognosis after AIS intravenous thrombolysis. This article reviews the relationship and the possible mechanisms between blood glucose and glycated hemoglobin and the prognosis, early neurological deterioration and SICH of AIS intravenous thrombolysis.