摘要
目的探讨急性脑梗死合并2型糖尿病(T2DM)患者时间窗内行血管介入治疗的预后影响因素。方法选择2016年9月至2019年9月焦作市人民医院神经内科收治的100例急性脑梗死合并T2DM患者为研究对象。患者均于时间窗内行血管介入治疗,术后随访90 d(失访2例),根据改良Rankin量表评分(mRS)将患者分为预后不良组(mRS≥4分,n=38)和预后良好组(mRS<4分,n=60)。采用单因素及多因素logistic回归分析影响患者预后的因素。结果98例患者中预后不良发生率为38.78%(38/98)。年龄≥60岁、T2DM病程、术前美国国立卫生研究院卒中量表(NIHSS)评分、基底动脉梗死、糖化血红蛋白(HbAlc)是影响急性脑梗死合并T2DM患者时间窗内行血管介入治疗预后的因素(P<0.05);性别、体质量指数、高血压史、冠状动脉性心脏病史、高脂血症史、吸烟史、酗酒史、股动脉穿刺至血管再通时间、介入治疗方式及随机血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、C反应蛋白水平与急性脑梗死合并T2DM患者时间窗内行血管介入治疗的预后无关(P>0.05)。Logistic回归分析结果显示,HbAlc、术前NIHSS评分、T2DM病程、基底动脉梗死是影响急性脑梗死合并T2DM患者时间窗内行血管介入治疗预后的独立因素(P<0.05)。结论急性脑梗死合并T2DM患者在时间窗内行血管内介入治疗预后不良发生率仍较高,NIHSS评分、HbAlc、T2DM病程及基底动脉梗死是影响患者预后的因素。
Objective To investigate the prognostic factors of patients with acute cerebral infarction combined with type 2 diabetes mellitus(T2DM)undergoing the endovascular interventional therapy within the time window.Methods A total of 100 patients with acute cerebral infarction combined with T2DM who were treated in the Department of Neurology of Jiaozuo People′s Hospital from September 2016 to September 2019 were selected as the research objects.All patients underwent endovascular interventional therapy within the time window.They were followed up for 90 days after operation.Two patients were lost to follow-up.The patients were divided into poor prognosis group[modified Rankin scale score(mRS)≥4,n=38]and good prognosis group(mRS<4,n=60)according to the modified mRS.Univariate and multivariate logistic regression were used to analyze the factors influencing the prognosis of patients.Results In the 98 patients,the incidence of poor prognosis was 38.78%(38/98).The age≥60 years old,the duration of T2DM,the preoperative National Institutes of Health stroke scale(NIHSS)score,basilar artery infarction and glycosylated hemoglobin A1C(HbAlc)level were the factors influencing the prognosis of patients with acute cerebral infarction combined with T2DM who underwent endovascular interventional therapy within the time window(P<0.05);the gender,body mass index,history of hypertension,history of coronary heart disease,history of hyperlipidemia,history of smoking,history of alcoholism,the time from femoral artery puncture to vascular recanalization,the mode of interventional therapy and the levels of random blood glucose,triacylglycerol,total cholesterol,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol and C-reactive protein were not associated with the prognosis of patients with acute cerebral infarction combined with T2DM who underwent endovascular interventional therapy within the time window(P>0.05).Logistic regression analysis showed that HbAlc,preoperative NIHSS score,the duration of T2DM and basilar artery infarction were independent factors influencing the prognosis of patients with acute cerebral infarction combined with T2DM who underwent endovascular interventional therapy within the time window(P<0.05).Conclusion The incidence of poor prognosis of patients with acute cerebral infarction combined with T2DM who undergo the endovascular interventional therapy within the time window is still high.The NIHSS score,HbAlc level,duration of T2DM and basilar artery infarction are factors influencing the prognosis of patients.
作者
钱琪
韩凯
冯陆
QIAN Qi;HAN Kai;FENG Lu(Department of Neurology,Jiaozuo People′s Hospital,Jiaozuo 454150,Henan Province,China)
出处
《新乡医学院学报》
CAS
2022年第6期528-532,共5页
Journal of Xinxiang Medical University
关键词
急性脑梗死
2型糖尿病
血管内介入治疗
预后
acute cerebral infarction
type 2 diabetes mellitus
endovascular interventional therapy
prognosis
