摘要
目的 分析血糖变异性与糖尿病合并急性期脑卒中患者短期不良预后的相关性.方法 回顾性分析2015年6月至2018年10月150例糖尿病合并急性期脑卒中患者的临床及随访资料.根据GluSD水平将血糖变异组分为低、中、高三位组,比较血糖变异各组中CGM指标及短期预后相关指标水平及采用多因素Logistic回归分析影响糖尿病合并急性期脑卒中患者短期不良预后的危险因素.结果 血糖变异组GluMAGE、GluAve、GluCV、GluGLI、HbAlc、FPG水平均较非血糖变异组高(P<0.05);三组HbAlc、FPG水平比较差异无统计学意义(P>0.05),高分位组GluMAGE、GluAve、GluCV、GluGLI水平均较低、中位组高(P<0.05),低、中位组比较差异无统计学意义(P>0.05);低、中分位组治疗15d时NIHSS评分均较入院时降低,Barthl指数、MoCA评分均较入院时升高(P<0.05),高分位组治疗15d时NIHSS评分略低于入院时,Barthl指数、MoCA评分略高于治疗前,但差异无统计学意义(P>0.05),且随着GluSD水平的上升在治疗15d时NIHSS评分呈升高趋势,Barthl指数、MoCA评分呈下降趋势(P<0.05);年龄(OR=1.764,95%CI:1.070~2.910)、HbAlc(OR=1.925,95%CI:1.071~3.459)、NIHSS评分(OR=1.989,95%CI:1.107~3.575)、GluCV(OR=2.149,95%CI:1.303~3.543)、GluAve(OR=2.092,95%CI:1.164~3.758)是糖尿病合并急性期脑卒中患者短期不良预后的危险因素(P<0.05).结论 血糖变异性和糖尿病合并急性期脑卒中患者短期不良预后密切相关,临床上应控制血糖波动,有利于改善患者的预后.
Objective To analyze the correlation between blood glucose variability and short-term poor prognosis in patients with diabetes mellitus and acute stroke.Methods 150 patients with diabetes mellitus complicated with acute stroke were selected from June 2015 to October 2018,and the clinical and follow-up data of all patients were analyzed retrospectively.According to the level of GluSD,the variation components of blood sugar were divided into three groups:low,medium and high.The levels of CGM and short-term prognostic indexes in blood glucose variation groups and the risk factors of short-term poor prognosis of diabetic patients with acute stroke were compared by multivariate Logistic regression analysis.Results The levels of GluMAGE,GluAve,GluCV,GluGLI,HbAlc and FPG in the blood glucose variation group were higher than those in the non-blood glucose variation group(P<0.05).The levels of HbAlc and FPG in the three groups were not significant(P>0.05).The levels of GluMAGE,GluAve,GluCV,GluGLI in the high score group were lower than those in the middle group(P<0.05),but there was no significant difference between the low and median groups(P>0.05).In the low and middle quantile group,the NIHSS score was lower than that in the admission day,and the Barthl index and MoCA score were higher than those in the admission group(P<0.05).The NIHSS score at the 15th day after treatment in the high score group was slightly lower than that at the admission day,and the Barthl index and MoCA score were slightly higher than those before the treatment.But there was no statistical difference(P>0.05),and the NIHSS score increased at the 15th day after treatment with the increase of GluSD level,and the Barthl index and MoCA score decreased(P<0.05).Age(OR=1.764,95%CI:1.070~2.910),HbAlc(OR=1.925,95%CI:1.071~3.459),NIHSS(OR=1.989,95%CI:1.107~3.575),GluCV(OR=2.149,95%CI:1.303~3.543)and GluAve(OR=2.092,95%CI:1.164~3.758)were risk factors for short-term poor prognosis in patients with diabetes mellitus and acute stroke(P<0.05).Conclusion Blood glucose variability is closely related to the short term poor prognosis of patients with diabetes mellitus and acute stroke.It is necessary to control the fluctuation of blood glucose in clinic,which is helpful to improve the prognosis of patients with acute cerebral apoplexy.
出处
《浙江临床医学》
2019年第5期603-605,共3页
Zhejiang Clinical Medical Journal
基金
浙江省新苗人才计划项目(2018R410035)
国家级大学生创新创业训练计划项目(201710344005).
关键词
血糖变异性
糖尿病合并急性期脑卒中
短期
不良预后
相关性分析
Blood glucose variability
Diabetes mellitus with acute stroke
Short-term
adverse prognosis
Correlation analysis
