Correlation between estimated glucose disposal rate and the short-term thrombolytic prognosis of patients with acute cerebral infarction

IF 1.6 4区 医学 Q3 CLINICAL NEUROLOGY
Xuyou Zhou, Weiwei Ji, Xia Lu, Juan Qu, Jin Hu
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Abstract

Objective

To investigate the correlation between the estimated glucose disposal rate (eGDR) and the short-term thrombolytic prognosis of patients with acute cerebral infarction.

Methods

A total of 214 patients with acute cerebral infarction who received thrombolytic treatment in our hospital from January 2022 to December 2023 were selected. The clinical data of the patients were collected, including general conditions, laboratory tests, etc. The eGDR was calculated using the homeostasis model assessment method and divided into four groups according to the quartiles of eGDR. The differences in clinical data among the groups were compared. According to the prognosis of the patients after thrombolysis, they were divided into the favorable functional outcome (modified Rankin scale 0–2 points) and the poor functional outcome group (modified Rankin scale 3–6 points). The eGDR and other clinical indicators of the two groups of patients were compared. Finally, univariate and multivariate analyses were used to evaluate the correlation between eGDR and related results.

Results

The median value of eGDR was 7.07 mg/kg/min (interquartile range, 6.15–9.23). Among them, the history of diabetes, BMI, HbA1c, triglycerides, and fasting blood glucose had statistical differences in the four subgroups (P < 0.05). The eGDR of the patients in the good prognosis group was significantly higher than that in the poor prognosis group (P < 0.05), while the systolic blood pressure, BMI, HbA1c, fasting blood glucose, NIHSS score at admission, and mRS score at admission were all lower than those in the poor prognosis group (P < 0.05). Multivariate Logistic regression analysis showed that the hemorrhagic transformation rate in the low eGDR group was still significantly higher than that in the high eGDR group (adjusted OR 1.24, [95 %CI: 1.02–1.45; p < 0.01]); the rates of favorable functional outcome (mRS score 0–2 points) and excellent functional outcome (mRS score 0–1 points) had statistical differences, and the high eGDR group was significantly higher than the low eGDR group. However, the rate of worse ending or death did not show a statistical difference.

Conclusion

eGDR is closely related to the thrombolytic prognosis of patients with acute cerebral infarction and can be used as an important indicator for evaluating the prognosis of patients.
急性脑梗死患者估计葡萄糖处置率与短期溶栓预后的相关性
目的探讨急性脑梗死患者葡萄糖处置率(eGDR)与短期溶栓预后的关系。方法选择2022年1月至2023年12月在我院接受溶栓治疗的急性脑梗死患者214例。收集患者的临床资料,包括一般情况、实验室检查等。采用稳态模型评估法计算eGDR,并根据eGDR的四分位数分为四组。比较两组临床资料的差异。根据患者溶栓后的预后情况分为功能良好组(改良Rankin评分0 ~ 2分)和功能不良组(改良Rankin评分3 ~ 6分)。比较两组患者的eGDR等临床指标。最后,采用单因素和多因素分析来评估eGDR与相关结果的相关性。结果eGDR中位数为7.07 mg/kg/min(四分位数区间为6.15 ~ 9.23)。其中,糖尿病史、BMI、HbA1c、甘油三酯、空腹血糖在4个亚组间有统计学差异(P <; 0.05)。预后良好组患者的eGDR显著高于预后差组(P <; 0.05),入院时收缩压、BMI、HbA1c、空腹血糖、入院时NIHSS评分、mRS评分均低于预后差组(P <; 0.05)。多因素Logistic回归分析显示,低eGDR组出血转化率仍显著高于高eGDR组(调整OR为1.24,[95 %CI: 1.02-1.45; p <; 0.01]);功能转归良好(mRS评分0 ~ 2分)和功能转归优(mRS评分0 ~ 1分)的比率有统计学差异,且高eGDR组显著高于低eGDR组。然而,更糟糕的结局或死亡率没有统计学差异。结论egdr与急性脑梗死患者的溶栓预后密切相关,可作为评价患者预后的重要指标。
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来源期刊
Clinical Neurology and Neurosurgery
Clinical Neurology and Neurosurgery 医学-临床神经学
CiteScore
3.70
自引率
5.30%
发文量
358
审稿时长
46 days
期刊介绍: Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.
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