静脉溶栓后急性缺血性脑卒中患者胰岛素抵抗标志物与预后不良之间的关系

IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Neurologist Pub Date : 2024-07-01 DOI:10.1097/NRL.0000000000000550
Haimei Liu, Denglu Liu, Peng Zuo
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引用次数: 0

摘要

研究目的本研究旨在探讨胰岛素抵抗指标对急性缺血性脑卒中(AIS)患者静脉溶栓后不良预后的预测意义,并建立相应的提名图:选取2019年1月至2023年3月在南京医科大学附属泰州人民医院接受静脉阿替普酶溶栓治疗的412例AIS患者资料。患者被随机分为训练组(70%,288 例)和验证组(30%,124 例)。在训练组中,采用多元逻辑回归分析建立最佳提名图预测模型。接收者操作特征曲线下面积、校准曲线、决策曲线分析和再分类分析进一步评估了提名图的预测能力。此外,该模型还在验证集中得到了进一步验证:多变量逻辑回归分析显示,收缩压、糖尿病、美国国立卫生研究院卒中量表评分、甘油三酯-葡萄糖指数、甘油三酯-葡萄糖-体重指数、低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值与静脉溶栓后 AIS 患者的不良预后有关(PConclusions:入院时的甘油三酯-葡萄糖指数、甘油三酯-葡萄糖-体重指数以及低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值可作为静脉溶栓后AIS患者预后不良的标志。该提名图能更准确地预测静脉溶栓后 AIS 患者的不良预后。
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Association Between Insulin Resistance Markers and Poor Prognosis in Patients With Acute Ischemic Stroke After Intravenous Thrombolysis.

Objectives: This study aims to investigate the significance of insulin resistance markers in predicting poor prognosis in acute ischemic stroke (AIS) patients after intravenous thrombolysis and to establish the corresponding nomogram.

Methods: From January 2019 to March 2023, the data of 412 patients with AIS who received intravenous alteplase thrombolytic therapy in the Affiliated Taizhou People's Hospital of Nanjing Medical University were selected. Patients were randomly divided into training groups (70%, 288 cases) and validation groups (30%, 124 cases). In the training group, multivariate logistic regression analysis was used to establish the best nomogram prediction model. The predictive ability of the nomogram was further evaluated by the area under the receiver operating characteristic curve, calibration curve, decision curve analysis, and reclassification analysis. Furthermore, the model was further validated in the validation set.

Results: Multivariate logistic regression analysis showed that systolic blood pressure, diabetes, National Institutes of Health Stroke Scale score, triglyceride-glucose index, triglyceride-glucose-body mass index, ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol were associated with poor prognosis in AIS patients after intravenous thrombolysis ( P <0.05). Compared with conventional factors, the nomogram showed stronger prognostic ability, area under receiver operating characteristic curves were 0.948 (95% CI: 0.920-0.976, P <0.001) and 0.798 (95% CI: 0.747-0.849, P <0.001), respectively.

Conclusions: Triglyceride-glucose index, triglyceride-glucose-body mass index, and low-density lipoprotein cholesterol to high-density lipoprotein cholesterol levels upon admission can serve as markers for poor prognosis in AIS patients after intravenous thrombolysis. The nomogram enables a more accurate prediction of poor prognosis in AIS patients after intravenous thrombolysis.

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来源期刊
Neurologist
Neurologist 医学-临床神经学
CiteScore
1.90
自引率
0.00%
发文量
151
审稿时长
2 months
期刊介绍: The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.
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