摘要
目的评估C反应蛋白-甘油三酯-葡萄糖指数(C-reactive protein-triglyceride glucose index,CTI)对进展性卒中的影响,为该类患者的炎症、血糖及血脂水平综合管理提供新的证据和指导。方法本研究纳入了2019年1月—2024年12月在沧州市人民医院就诊的1355例缺血性卒中患者,终点事件为住院期间是否发生进展性卒中。采用logistic回归分析、亚组分析、ROC曲线探讨CTI与进展性卒中的关系。结果共365例(26.94%)患者发生进展性卒中。校正混杂因素后,多因素logistic回归分析显示,CTI(OR 2.230,95%CI 1.957~2.542,P<0.001)是进展性卒中的独立危险因素,最高四分位区间患者比最低四分位区间患者的进展性卒中发生风险高3.016倍(OR 4.016,95%CI 1.946~8.290,P<0.001)。亚组分析显示,CTI在年龄、性别、吸烟史、饮酒史、高血压病史、糖尿病病史、冠心病病史亚组中仍保持上述关系,且与年龄、高血压病史、糖尿病病史之间存在交互作用。ROC曲线分析显示,C反应蛋白(C-reactive protein,CRP)预测进展性卒中的AUC为0.690(95%CI 0.660~0.720),甘油三酯-葡萄糖(triglyceride-glucose,TyG)预测进展性卒中的AUC为0.614(95%CI 0.588~0.640),CTI预测进展性卒中的AUC为0.711(95%CI 0.686~0.735),CTI的预测价值高于CRP(Z=1.958,P=0.043)和TyG(Z=6.565,P<0.001)。结论CTI对进展性卒中具有一定的独立预测价值,这一综合了炎症、血糖及血脂水平的指标能够进一步提升预测进展性卒中的准确性,具有更佳的临床应用前景。
Objective To assess the effects of the C-reactive protein-triglyceride glucose index(CTI)on progressive stroke,and to provide new evidence and guidance for the comprehensive management of inflammation,blood glucose,and lipid levels in such patients.Methods This study included 1355 patients with ischemic stroke who were admitted to the Cangzhou People’s Hospital from January 2019 to December 2024.The endpoint event was the occurrence of a progressive stroke during hospitalization.Logistic regression analysis,subgroup analysis,and the ROC curve were used to investigate the relationship between the CTI and progressive stroke.Results A total of 365 patients(26.94%)experienced progressive stroke.After adjusting for confounding factors,multivariate logistic regression analysis revealed that CTI(OR 2.230,95%CI 1.957-2.542,P<0.001)was an independent risk factor for progressive stroke.The risk of progressive stroke in the highest quartile range was 3.016-fold higher than that in the lowest quartile range(OR 4.016,95%CI 1.946-8.290,P<0.001).The subgroup analysis revealed that CTI maintained this relationship in subgroups of age,gender,history of smoking,history of drinking,history of hypertension,history of diabetes mellitus,and history of coronary heart disease,and showed interaction with age,history of hypertension,and history of diabetes mellitus.ROC curve analysis showed that the AUC of C-reactive protein(CRP)for predicting progressive stroke was 0.690(95%CI 0.660-0.720),that of the triglyceride-glucose(TyG)index was 0.614(95%CI 0.588-0.640),and that of CTI was 0.711(95%CI 0.686-0.735).The predictive value of CTI was higher than that of CRP(Z=1.958,P=0.043)and TyG(Z=6.565,P<0.001).Conclusions CTI has a certain independent predictive value for progressive stroke.This integrated indicator,which combines inflammation,blood glucose,and lipid levels,can further improve the accuracy of predicting progressive stroke,and thus has better prospects for clinical application.
作者
于骁
孙亚召
黄捷
YU Xiao;SUN Yazhao;HUANG Jie(Graduate School of Chengde Medical University,Chengde 067000,China;Department of Cardiology,Cangzhou People’s Hospital,Cangzhou 061000,China;Department of Neurology,Cangzhou People’s Hospital,Cangzhou 061000,China)
出处
《中国卒中杂志》
北大核心
2025年第8期977-984,共8页
Chinese Journal of Stroke
