Diabetes Care:卒中前血糖控制与急性大血管闭塞性卒中的糖尿病患者功能结局的关系

2021-07-09 MedSci原创 MedSci原创

对于因大血管闭塞性卒中而接受IAT治疗的糖尿病患者,无论卒中亚型、溶栓方式、闭塞部位、再通程度和治疗时间,卒中前血糖控制可能有利于神经功能恢复。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,该研究旨在评估卒中前血糖控制是否与接受动脉内血栓摘除(IAT)的急性大血管闭塞性卒中和糖尿病患者功能结局相关。

研究人员从韩国卒中临床研究中心纳入了2009年1月至2020年3月期间接受IAT治疗的急诊大血管闭塞性卒中的糖尿病患者,并评估了入院时糖化血红蛋白(HbA1c)水平与患者功能结局(卒中后3个月的改良Rankin量表)之间的关系。

该研究共有1351例患者纳入进行了分析。入院时HbA1c水平较高的患者早期神经功能恶化更为常见(根据HbA1c水平五分位数,P=0.02;根据HbA1c临界值为7.0%,P=0.003),相比于HbA1c水平较低的患者。

卒中前血糖控制对神经系统结局的影响

入院时较高的HbA1c水平与良好的功能结局几率降低(阈值为7.0-7.1%)显著相关。在按年龄、性别、卒中亚型、闭塞部位、再通程度、溶栓方式、从症状出现到腹股沟穿刺的时间和治疗时间划分的亚组中,研究人员观察到了一致的相关性。

由此可见,对于因大血管闭塞性卒中而接受IAT治疗的糖尿病患者,无论卒中亚型、溶栓方式、闭塞部位、再通程度和治疗时间,卒中前血糖控制可能有利于神经功能恢复。
 
原始出处:
 
Jun Young Chang,et al.Prestroke Glucose Control and Functional Outcome in Patients With Acute Large Vessel Occlusive Stroke and Diabetes After Thrombectomy.Diabetes care.2021.https://doi.org/10.2337/dc21-0271

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time=2021-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=998169, encodeId=80c1998169a9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=abe25434876, createdName=ms6000000196724174, createdTime=Sat Jul 10 10:52:22 CST 2021, time=2021-07-10, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2009879, encodeId=426120098e95a, content=<a href='/topic/show?id=467789803a9' target=_blank style='color:#2F92EE;'>#血管闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89803, encryptionId=467789803a9, topicName=血管闭塞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=827b160, createdName=cnxcy, createdTime=Mon Apr 04 10:45:55 CST 2022, time=2022-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902588, encodeId=22a619025885f, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, 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content=<a href='/topic/show?id=10333293491' target=_blank style='color:#2F92EE;'>#功能结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32934, encryptionId=10333293491, topicName=功能结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d275294, createdName=andy2087, createdTime=Sun Jul 11 03:45:55 CST 2021, time=2021-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475102, encodeId=2c1814e510248, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Sun Jul 11 03:45:55 CST 2021, time=2021-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=998169, encodeId=80c1998169a9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=abe25434876, createdName=ms6000000196724174, createdTime=Sat Jul 10 10:52:22 CST 2021, time=2021-07-10, status=1, ipAttribution=)]
  6. 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objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43986, encryptionId=7f6443986ec, topicName=大血管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=caff31165455, createdName=kkunny, createdTime=Thu Jul 15 01:45:55 CST 2021, time=2021-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273044, encodeId=6ad212e3044d5, content=<a href='/topic/show?id=2f468983351' target=_blank style='color:#2F92EE;'>#血糖控制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89833, encryptionId=2f468983351, topicName=血糖控制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Sun Jul 11 03:45:55 CST 2021, time=2021-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1301088, encodeId=a8b21301088a5, content=<a href='/topic/show?id=10333293491' target=_blank style='color:#2F92EE;'>#功能结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32934, encryptionId=10333293491, topicName=功能结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d275294, createdName=andy2087, createdTime=Sun Jul 11 03:45:55 CST 2021, time=2021-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475102, encodeId=2c1814e510248, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Sun Jul 11 03:45:55 CST 2021, time=2021-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=998169, encodeId=80c1998169a9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=abe25434876, createdName=ms6000000196724174, createdTime=Sat Jul 10 10:52:22 CST 2021, time=2021-07-10, status=1, ipAttribution=)]
    2021-07-15 kkunny
  7. 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  8. 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    2021-07-10 ms6000000196724174

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