神经损伤与功能重建
神經損傷與功能重建
신경손상여공능중건
NEURAL INJURY AND FUNCTIONAL RECONSTRUCTION
2014年
2期
115-118
,共4页
糖化血红蛋白%糖尿病%缺血性脑卒中%预测价值
糖化血紅蛋白%糖尿病%缺血性腦卒中%預測價值
당화혈홍단백%당뇨병%결혈성뇌졸중%예측개치
glycosylated hemoglobin%diabetes mellitus%ischemic stroke%predictive value
目的：探讨糖化血红蛋白水平（HbA1c）对糖尿病（DM）并发缺血性脑卒中（IS）患者再次脑血管事件(SCE)的预测作用。方法：连续收集2008年6月至2011年6月DM并发IS患者168例。入院后测定HbA1c水平，收集临床资料。依据HbA1c水平将患者分为HbA1c升高组（HbA1c≥6.1%）和HbA1c正常组（HbA1c＜6.1%）。对所有患者出院后18个月内SCE进行随访（每2个月一次），依据是否发生SCE将患者分为事件组和非事件组。采用受试者工作特征（ROC）曲线评价HbA1c水平对SCE的预测价值。结果：与HbA1c正常组（n＝75）相比，HbA1c升高组（n＝93）入院时空腹血糖、2 h餐后血糖、收缩压、胆固醇、甘油三酯及低密度脂蛋白胆固醇水平均升高，高密度脂蛋白胆固醇水平和Barthel指数均明显降低（均＜0.01）。事件组49例，HbA1c水平为（9.57±1.93）%；非事件组119例，HbA1c水平为（6.96±2.40）%，前者高于后者（＜0.01）。ROC曲线下面积为0.784（＜0.01，95%为0.713~0.855），取HbA1c水平6.55%为预测临界值的灵敏度和特异度分别为86.80%和64.30%。Kaplan-Meier生存曲线提示HbA1c水平≥6.55%时，SCE发生率增高（＜0.01）。结论：DM合并IS患者首次入院时HbA1c水平可能对出院后18个月内SCE进行预测。
目的：探討糖化血紅蛋白水平（HbA1c）對糖尿病（DM）併髮缺血性腦卒中（IS）患者再次腦血管事件(SCE)的預測作用。方法：連續收集2008年6月至2011年6月DM併髮IS患者168例。入院後測定HbA1c水平，收集臨床資料。依據HbA1c水平將患者分為HbA1c升高組（HbA1c≥6.1%）和HbA1c正常組（HbA1c＜6.1%）。對所有患者齣院後18箇月內SCE進行隨訪（每2箇月一次），依據是否髮生SCE將患者分為事件組和非事件組。採用受試者工作特徵（ROC）麯線評價HbA1c水平對SCE的預測價值。結果：與HbA1c正常組（n＝75）相比，HbA1c升高組（n＝93）入院時空腹血糖、2 h餐後血糖、收縮壓、膽固醇、甘油三酯及低密度脂蛋白膽固醇水平均升高，高密度脂蛋白膽固醇水平和Barthel指數均明顯降低（均＜0.01）。事件組49例，HbA1c水平為（9.57±1.93）%；非事件組119例，HbA1c水平為（6.96±2.40）%，前者高于後者（＜0.01）。ROC麯線下麵積為0.784（＜0.01，95%為0.713~0.855），取HbA1c水平6.55%為預測臨界值的靈敏度和特異度分彆為86.80%和64.30%。Kaplan-Meier生存麯線提示HbA1c水平≥6.55%時，SCE髮生率增高（＜0.01）。結論：DM閤併IS患者首次入院時HbA1c水平可能對齣院後18箇月內SCE進行預測。
목적：탐토당화혈홍단백수평（HbA1c）대당뇨병（DM）병발결혈성뇌졸중（IS）환자재차뇌혈관사건(SCE)적예측작용。방법：련속수집2008년6월지2011년6월DM병발IS환자168례。입원후측정HbA1c수평，수집림상자료。의거HbA1c수평장환자분위HbA1c승고조（HbA1c≥6.1%）화HbA1c정상조（HbA1c＜6.1%）。대소유환자출원후18개월내SCE진행수방（매2개월일차），의거시부발생SCE장환자분위사건조화비사건조。채용수시자공작특정（ROC）곡선평개HbA1c수평대SCE적예측개치。결과：여HbA1c정상조（n＝75）상비，HbA1c승고조（n＝93）입원시공복혈당、2 h찬후혈당、수축압、담고순、감유삼지급저밀도지단백담고순수평균승고，고밀도지단백담고순수평화Barthel지수균명현강저（균＜0.01）。사건조49례，HbA1c수평위（9.57±1.93）%；비사건조119례，HbA1c수평위（6.96±2.40）%，전자고우후자（＜0.01）。ROC곡선하면적위0.784（＜0.01，95%위0.713~0.855），취HbA1c수평6.55%위예측림계치적령민도화특이도분별위86.80%화64.30%。Kaplan-Meier생존곡선제시HbA1c수평≥6.55%시，SCE발생솔증고（＜0.01）。결론：DM합병IS환자수차입원시HbA1c수평가능대출원후18개월내SCE진행예측。
ObjectiveTo observe the predictive value of glycosylated hemoglobin (HbA1c) level on the secondary cerebrovascular events (SCE)of diabetic patients with ischemic stroke. Methods:From June 2008 to June 2011, 168 diabetic patients with ischemic stroke were admitted. The patients were divided into elevated HbA1c group (HbA1c≥6.1%) and normal HbA1c group (HbA1c<6.1%). All the patients have been followed up every two month and the occurrence of SCE was documented in 18 months. According to the follow-up data, the patients were assigned into the event and non-event groups. The power of HbA1c levels to predict SCE was exam-ined by receiver operating characteristic (ROC) curve. Results:When compared with the normal HbA1c group (n=75), the fasting blood glucose, postprandial blood glucose, systolic pressure, cholesterol, triglyceride and low density lipoprotein cholesterol were significantly increased, while high density lipoprotein cholesterol and Barthel index were significantly decreased in elevated HbA1c group (n=93)(all <0.01). At the endpoint, there were 49 and 119 patients in the event group and non-event group respectively. When compared with the non-event group, the HbA1c level was higher in the event group [(6.96±2.40)% (9.57±1.93)%, <0.01). The area under the ROC curve (AUC) of HbA1c level to predict the SCE was 0.784 ( <0.01, 0.713~0.855). The cut-off value of HbA1c was 6.55%, with a sensitivity of 86.80%and a specificity of 64.30%. The Kaplan-Meier survival curve showed that the occurrence of SCE was increased in the patients with HbA1c level≥6.55%. Conclusion:The ele-vated HbA1c level may be a significant predictor for SCE in diabetic patients with ischemic stroke in 18 months.
