高水平空腹血糖与缺血性卒中患者静脉溶栓后功能结局的关系分析OACSTPCD

Objective To investigate the association between fasting blood glucose and functional outcomes in ischemic stroke patients treated with intravenous thrombolysis. Methods The study data of patients treated with intravenous thrombolysis in Beijing Tiantan Hospital,Capital Medical University from October 2018 to November 2020 were collected retrospectively.Ischemic stroke patients who received alteplase intravenous thrombolysis within 4.5 h of onset were included,and study data including fasting blood glucose were collected.The study outcome was set as a good functional outcome at discharge(mRS score 0-1).Multivariate logistic regression analysis was used to investigate the association between the fasting blood glucose and functional outcomes. Results A total of 205 patients were enrolled.The mean age was(63.21±11.67)years.The percentage of male was 153(74.63％).The admission NIHSS score was 5(3-9).There were 117 patients(57.07％)who did not have a good functional outcome at discharge and 88 patients(42.93％)who did.Fasting blood glucose levels in patients with good functional outcomes were lower than those in patients with poor functional outcomes[5.10(4.46-7.06)mmol/L vs.6.33(5.09-7.79)mmol/L,P=0.001].Multivariate logistic regression analysis showed that after adjusting for age,gender,and NIHSS score,there was a correlation between fasting blood glucose level and the outcome of receiving intravenous thrombolysis(OR 0.876,95％CI 0.774-0.991,P=0.035).After adjusting for age,sex,NIHSS score and mechanical thrombectomy,the association was not statistically significant(OR 0.891,95％CI 0.791-1.004,P=0.058). Conclusions In ischemic stroke patients undergoing intravenous thrombolysis,high level of fasting blood glucose may increase the risk of adverse discharge outcomes after intravenous thrombolysis.