应激性高血糖比值与急性缺血性脑卒中患者 早期神经功能恶化的相关性研究
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肖仕艳,女,在读硕士研究生,拟研究方向为急危重症护理学。

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R 743.3

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深圳市科创委科技 “ 自由探索 ” 项目(JCYJ20180228163026995);深圳市高水平医院建设项目深圳市 第二人民医院临床研究项目(20223357018)


Correlation between Stress Hyperglycemia Ratio and Early Neurological Deterioration of Patients with Acute Ischemic Stroke
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    摘要:

    摘 要目的:探讨应激性高血糖比值(SHR)与急性缺血性脑卒中(AIS)患者早期神经功能恶化(END) 的关系。 方法:连续性收集 2023 年 1 月至 2023 年 6 月就诊于深圳市 3 家三级甲等综合医院的 AIS 患者临床资料和 血液生化指标,根据患者有无发生 END 将患者分为 END 组和非 END 组。采用多因素 logistic 回归分析 SHR 是否为 AIS 患者 END 的影响因素,采用受试者工作特征(ROC)曲线分析 SHR 对 END 的预测价值。 结果:共纳入 277 例 患者,发生 END 者 48 例(17.33 %)。非 END 组 SHR 水平低于 END 组[0.87(0.15)vs 0.98(0.27),P = 0.001]。 多因素 logistic 回归分析显示,与较低 SHR 组相比,高 SHR 组患者 END 发生风险增加[调整后 OR = 4.487,95 % CI(1.167,20.127),P = 0.030]。亚组分析结果显示,在非糖尿病患者组中,以上结果差异具有统计学意义 [OR = 4.903,95 % CI(1.320,18.206),P = 0.018],而在糖尿病患者组中差异无统计学意义[OR = 0.793,95 % CI(0.056 ,11.242),P = 0.084)。SHR 预测 AIS 患者发生 END 的曲线下面积为 0.655[95 % CI(0.570,0.740), P = 0.001],SHR 的约登指数为 0.275,灵敏度为 72.9 %,特异度为 54.6 %。 结论:HR 升高与 AIS 患者发生 END 的风险增加有关,可预测 AIS 患者 END 的发生。

    Abstract:

    AbstractObjective To investigate the relationship between stress hyperglycemia ratio (SHR) and early neurological deterioration (END) in patients with acute ischemic stroke (AIS). Methods Clinical data and blood biochemical indexes of AIS patients attending three tertiary general hospitals in Shenzhen City from January 2023 to June 2023 were collected consecutively, and patients were divided into END and non-END groups according to the presence or absence of END. Multifactorial logistic regression was used to analyze whether influencing stress hyperglycemia ratio was a influence factor for END in AIS patients, and the predictive value of SHR for END was analyzed by using receiver operating characteristic (ROC) curve. Results A total of 277 patients were included, and 48 (17.33%) had END. The SHR level was lower in the non-END group than that in the END group [0.87 (0.15) vs 0.98 (0.27),P = 0.001]. Multifactorial logistic regression analysis showed that patients in the high SHR group had an increased risk of END compared to the lower SHR group [adjusted OR = 4.487, 95% CI (1.167, 20.127), P = 0.030]. Subgroup analysis showed that the difference between the above results was statistically significant in the non-diabetic group [OR = 4.903, 95% CI (1.320, 18.206), P = 0.018], whereas the difference was not statistically significant in the diabetic group [OR = 0.793, 95% CI ( 0.056, 11.242), P = 0.084]. SHR predicted the END in patients with ischemic stroke had an area under the curve of 0.655 [95% CI (0.570, 0.740), P = 0.001], and Youden index for SHR was 0.275, with a sensitivity of 72.9 % and a specificity of 54.6 %. Conclusion Elevated HR is associated with an increased risk of END in patients with AIS and could predict the occurrence of END in patients with AIS.

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  • 收稿日期:2023-11-13
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  • 在线发布日期: 2024-06-07
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