糖化血红蛋白与急性脑桥梗死患者预后的关系

  目的  探讨糖化血红蛋白(HbA1c)与急性脑桥梗死患者预后的关系。  方法  分析2016年5月—2018年4月合肥市第八人民医院神经内科的85例急性脑桥梗死患者既往糖尿病史、入院后空腹血糖、HbA1c等因素与患者90 d随访时的改良Rankin评分(mRS)、日常生活自理能力(ADL)评分的关系。  结果  HbA1c与脑桥梗死患者90 d预后良好(mRS＜3分)相关(OR=0.234，95% CI:0.073~0.784，P=0.014)；HbA1c≥6.1%(OR=0.404，95% CI:0.138~1.188，P=0.100)、糖尿病史(OR=0.556，95% CI:0.197~1.565，P=0.266)、空腹血糖≥7.0 mmol/L(OR=0.516，95% CI:0.179~1.488，P=0.221)与患者90 d随访时日常生活自理能力(ADL＞60分)不相关。HbA1c相比较糖尿病史及空腹血糖具有更高的AUC值(mRS＜3分，AUC=0.725，95% CI:0.615~0.835，P=0.001；ADL＞60分，AUC=0.682，95% CI:0.556~0.808，P=0.016)。  结论  相比于糖尿病史及空腹血糖等因素，HbA1c在评价急性脑桥梗死患者预后方面可能更具有优势。 

Relationship between glycosylated haemoglobin and prognosis of patients with acute pontine infarction

  Objective  To investigate the relationship between glycosylated haemoglobin (HbA1c) and prognosis of patients with acute pontine infarction.  Methods  The relationship between the history of diabetes, fasting blood glucose and HbA1c after admission, and the scores of modified Rankin score (mRS) and daily life self-care ability (ADL) at 90 d follow-up in 85 patients with acute pontine infarction in Hefei Eighth People's Hospital from May 2016 to April -2018 were analysed.  Results  A significant correlation between HbA1c and prognosis (mRS < 3) was observed in patients with pontine infarction at 90-day follow-up (OR=0.234, 95% CI: 0.073-0.784, P=0.014). In addition, no significant correlation amongst HbA1c ≥ 6.1% (OR=0.404, 95% CI: 0.138-1.188, P=0.100), history of diabetes (OR=0.556, 95% CI: 0.197-1.565, P=0.266), fasting blood glucose ≥ 7.0 mmol/L (OR=0.516, 95% CI: 0.179-1.488, P=0.221) and ADL>60 was observed in patients at 90-day follow-up. HbA1c had higher AUC value (mRS < 3, AUC=0.725, 95% CI: 0.615-0.835, P=0.001; ADL>60, AUC=0.682, 95% CI: 0.556-0.808, P=0.016) than diabetes history and fasting blood glucose.  Conclusion  Compared with fasting blood glucose and diabetes history, glycosylated haemoglobin may have an advantage in evaluating the prognosis of patients with acute pontine infarction.