糖化血红蛋白预测脑梗死rt-PA静脉溶栓患者预后的研究

目的 探讨糖化血红蛋白(HbA1c)预测脑梗死重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓患者预后的价值.方法 回顾性分析淮安市金湖县人民医院神经内科2018年6月至2020年1月接受rt-PA静脉溶栓治疗的50例急性脑梗死患者的临床资料,依据患者短期预后情况分为预后良好组(27例)与预后不良组(23例).对比两组一...

Study of glycosylated hemoglobin in predicting prognosis in patients with cerebral infarction and rt-PA intravenous thrombolysis

Objective To explore the value of glycosylated hemoglobin(HbA1c)in predicting the prognosis of the patients with cerebral infarction and recombinant tissue-type plasminogen activator(rt-PA)intravenous thrombolysis.Methods The clinical data of a total of 50 patients with acute cerebral infarction receiving rt-PA intravenous thrombolytic therapy in Department of Neurology in Jinhu County People′s Hospital in Huai′an from June 2018 to January 2020 were retrospectively analyzed.According to the short-term prognosis,the patients were divided into the good prognosis group(27 cases)and poor prognosis group(23 cases).The differences in general data and laboratory detection results were compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the value of HbA1c level to predict the prognosis in the patients with cerebral infarction and rt-PA intravenous thrombolysis,and the multivariate Logistic regression was used to analyze the risk factors for poor prognosis of the patients with cerebral infarction and rt-PA intravenous thrombolysis.The Spearman correlation was used to analyze the correlation between the HbA1c level with the MRS score and NIHSS score.Results The univariate analysis showed that the age,gender,hypertension history and smoking history had no statistical difference between the two groups(P>0.05);the time from onset to thrombolysis in the good prognosis group was shorter than that in the poor prognosis group,and NIHSS score,MRS score and HbA1c level in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).The ROC curve analysis indicated that the area under the curve of HbA1c in predicting prognosis in patients with cerebral infarction and rt-PA intravenous thrombolysis was 0.738,95%CI was 0.651-0.825,the cut-off value was 6.785 mmol/L,the sensitivity was 0.567,and the specificity was 0.750.The Logistic regression indicated that the time from onset to thrombolysis,NIHSS score,MRS score and HbA1c were the risk factors for poor prognosis in the patients with cerebral infarction and rt-PA intravenous thrombolysis(P<0.05).The HbA1c level was positively correlated with the MRS score and NIHSS score(P<0.05).Conclusion Detecting the HbA1c level has a certain guidance value in the prognosis evaluation of the patients with cerebral infarction and rt-PA intravenous thrombolysis.