入院时的非空腹血糖水平与脑静脉血栓的预后有关

Passara Cheawprasit, Witoon Mitarnun
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背景与目的:脑静脉血栓形成(CVT)是一种罕见的脑卒中。本研究旨在调查 CVT 患者的特征、结局和预后因素。研究方法这是一项为期五年的回顾性研究,研究对象为 2016 年 4 月至 2021 年 4 月在本院住院的 CVT 患者。研究人员调阅了病历,以确诊并获得临床、影像学、实验室和治疗数据。此外,还收集了患者三个月后的治疗结果。采用二元逻辑回归分析预后因素。结果共分析了 73 名 CVT 患者(35.6% 为男性;平均年龄 44.3 岁)。17.8%的患者预后不佳(改良兰金量表评分 3-6 分),死亡率为 10.9%。与所有 CVT 患者不良预后相关的因素包括:症状持续时间<24 小时(OR:3.95,95% CI:1.13-13.82)、年龄≥50 岁(OR:8.12,95% CI:2.16-30.71)、非空腹血糖水平≥200 mg/dL(OR:9.58,95% CI:1.90-48.25)、意识障碍(格拉斯哥昏迷量表评分,3-8)(OR:5.63,95% CI:1.39-22.81)、男性(OR:3.73,95% CI:1.07-12.98)和脑疝(中线移位≥5 mm)(OR:8.75,95% CI:1.94-39.57)。头痛和口服避孕药与所有患者的良好预后有关。结论作为一个可改变预后的因素,非空腹血糖水平与 CVT 患者不良预后的相关性最高。
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Non-fasting Glucose Level at Admission Associated with Outcomes in Cerebral Venous Thrombosis
Background and Purpose: Cerebral venous thrombosis (CVT) is a rare form of stroke. The objective of this study was to investigate the characteristics, outcomes, and prognostic factors of CVT patients. Methods: This is a five-year retrospective study of CVT patients admitted to our Hospital from April 2016 to April 2021. Medical records were accessed to confirm the diagnosis and obtain the clinical, imaging, laboratory, and treatment data. Further, outcomes of the patients at three months were collected. Binary logistic regression was used to analyse the prognostic factors. Results: Seventy-three patients with CVT were analysed (35.6% male; mean age, 44.3 years). A poor outcome (modified Rankin scale score, 3–6) was 17.8% of patients, and mortality was 10.9%. Factors associated with poor outcomes in all patients with CVT included the duration of presenting symptoms <24 hours (OR: 3.95, 95% CI: 1.13–13.82), age ≥ 50 years (OR: 8.12, 95% CI: 2.16–30.71), a non-fasting glucose level of ≥ 200 mg/dL (OR: 9.58, 95% CI: 1.90–48.25), impaired consciousness (Glasgow coma scale score, 3–8) (OR: 5.63, 95% CI: 1.39–22.81), male sex (OR: 3.73, 95% CI: 1.07–12.98), and brain herniation (midline shift ≥ 5 mm) (OR: 8.75, 95% CI: 1.94–39.57). Headache and use of an oral contraceptive pill were associated with good outcomes in all of the patients. Conclusion: The non-fasting glucose level, a modifiable prognostic factor, exhibited the highest correlation with poor outcomes in CVT patients.
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