糖化血红蛋白预测急性卒中溶栓后症状性出血风险

目的探讨糖化血红蛋白（HbA1c）对症状性颅内出血（sICH）的预测价值。 方法纳入2017年5月至2020年5月连续就诊于江苏大学附属句容医院神经内科的急性缺血性卒中静脉溶栓患者，记录患者的基线资料，根据24 h内是否出现sICH分为非sICH组和sICH组，应用多因素Logistic回归模型分析HbA1c与sICH及3个月不良神经功能预后（mRs>2分）的关系。 结果共纳入142例患者，其中sICH组26例（18.3%）患者，非sICH组116（81.7%）例患者。Logistic多因素回归分析显示抗栓史、高HbA1c和入院美国国立卫生研究院卒中量表（NIHSS）评分是sICH的独立危险因素，2组患者3个月不良预后率分别为38%（10/26）、19%（22/116）。Logistic多因素回归分析显示入院血糖、发病至溶栓时间、HbA1c、基线NIHSS评分与3个月不良预后独立相关。 结论HbA1c是急性缺血性脑卒中溶栓sICH和3个月不良预后的重要预测因子。

Glycosylated hemoglobin A1 predicts risk for symptomatic hemorrhage after thrombolysis for acute stroke

ObjectiveTo determine the predictive value of glycosylated hemoglobin A1 (HbA1c) on symptomatic intracerebral hemorrhage (sICH). MethodsThe patients treated with thrombolysis were included in Neurology Department of Jurong Hospital affiliated to Jiangsu University from May 2017 to May 2020. Baseline data was obtained at admission. According to the presence of sICH within 24 h, the patients were divided into non-bleeding group and bleeding group. The relationship between HbA1c and sICH and the prognosis of poor neurological function at 3 months (mRs>2 scores) was analyzed by multivariate Logistic regression model. ResultsA total of 142 patients were included, among which 26(18.3%) patients in the sICH group and 116(81.7%) patients in the non-sICH group. Logistic multivariate regression analysis showed that history of antithrombotic therapy, high HbA1c and admission National Institute of Health stroke scale (NIHSS) score were independent risk factors for sICH, and poor prognosis at 3 months was 38% (10/26) and 19% (22/116), respectively. In multivariate analysis blood glucose at admission, time from onset to thrombolysis, HbA1c, and baseline NIHSS score were independently associated with poor prognosis at 3 months. ConclusionHbA1c turns out to be an important predictor of sICH after thrombolysi and poor prognosis at 3 months.