高度胰岛素抵抗可能与缺血性卒中溶栓后转归不佳相关

2011-09-15 MedSci原创 MedSci原创

 西班牙学者的一项研究表明,在急性缺血性卒中行溶栓治疗后,高度胰岛素抵抗(IR)可能与更为持续的动脉闭塞和更差的远期转归相关。论文于2011年9月12日在线发表于《糖尿病护理》(Diabetes Care)。   此项前瞻性、观察性、纵向研究序贯性入组急性缺血性卒中患者,受试者均伴有大脑中动脉(MCA)阻塞并且接受了静脉溶栓治疗。接受胰岛素治疗的急性高血糖患者(≥155 mg

 西班牙学者的一项研究表明,在急性缺血性卒中行溶栓治疗后,高度胰岛素抵抗(IR)可能与更为持续的动脉闭塞和更差的远期转归相关。论文于2011年9月12日在线发表于《糖尿病护理》(Diabetes Care)。

  此项前瞻性、观察性、纵向研究序贯性入组急性缺血性卒中患者,受试者均伴有大脑中动脉(MCA)阻塞并且接受了静脉溶栓治疗。接受胰岛素治疗的急性高血糖患者(≥155 mg/dl)被排除在外。在入院期间依据稳态模型评估指数(HOMA-IR)确定IR。依据90天改良Rankin量表评分 ≥3定义远期不良转归,并将其作为主要转归指标。次要终点为经颅多普勒评估的MCA再通抵抗和症状性出血性转化。

  结果显示,共有109例接受溶栓治疗的MAC缺血性卒中患者被纳入研究(女性43.1%,平均年龄71岁)。不良转归组患者的HOMA-IR较高(P=0.02)。随着HOMA-IR三分位值升高,出现良好转归的可能性逐渐降低(第一三分位80.6%,第二三分位55.3%,第三三分位 55.3%)。与最低三分位相比,处于最高三分位的HOMA-IR与不良转归呈独立相关(P=0.01),并且与更为持续的MAC闭塞相关(P=0.029)。

  链接:

  Insulin Resistance Is Associated With a Poor Response to Intravenous Thrombolysis in Acute Ischemic Stroke

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    2011-11-24 shirley

    These pieces really set a satndard in the industry.

    0

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    2012-03-04 baoya