中风与神经疾病杂志2026，Vol.43Issue(3)：238-243,6.DOI:10.19845/j.cnki.zfysjjbzz.2026.0041
应激性高血糖比率与大动脉粥样硬化型脑梗死患者卒中后认知功能障碍的相关性
Association between stress hyperglycemia ratio and post-stroke cognitive dysfunction in patients with large-artery atherosclerotic cerebral infarction
摘要
Abstract
Objective To investigate the association between stress hyperglycemia ratio(SHR)and post-stroke cogni-tive impairment(PSCI)in patients with large-artery atherosclerotic cerebral infarction.Methods The patients with large-artery atherosclerotic cerebral infarction who were consecutively admitted to Beijing Jingmei Group General Hospital from July 1,2023 to June 30,2024 were selected,and a total of 1 222 patients were included for analysis based on the inclusion and ex-clusion criteria.According to the tertiles of SHR,the patients were divided into low SHR group(L-SHR group,408 patients with an SHR of 0.175-0.764),middle SHR group(M-SHR group,407 patients with an SHR of 0.765-0.905),and high-SHR group(H-SHR group,407 patients with an SHR of 0.906-2.760).A univariate analysis was used for comparison of re-lated indicators between two groups,and the univariate and multivariate logistic regression analyses were used to identify the in-dependent influencing factors for PSCI;a restricted cubic spline analysis was used to clarify the association between SHR and PSCI,and a threshold effect analysis was performed.Results The incidence rate of PSCI was 16.3%(199/1 222)in all pa-tients undergoing follow-up.The H-SHR group had significant increases in age,MAP,NIHSS score on admission,MRS score at discharge,and the incidence rate of PSCI and significant reductions in MMSE score and the proportion of patients with a high education level(all P<0.05).After adjustment for related factors,high SHR(OR=5.19,95%CI 3.15-8.55,P<0.001)was an independent risk factor for PSCI in addition to old age,a high level of low-density lipoprotein,a high level of homocysteine,a high level of serum creatinine,a history of diabetes,and a high MRS score at discharge.There was an"inverted V-shaped"nonlinear relationship between SHR and the incidence rate of PSCI(Pfor overall<0.001,Pfor nonlinear<0.001),and there was a thresh-old effect in the relationship between them(Pfor likelihood test<0.001),;specifically,when SHR was less than 1.28,there was a positive association between SHR and PSCI(OR=93.26,95%CI 27.23-319.42),and when SHR was higher than 1.28,there was a negative association between SHR and PSCI(OR=0.08,95%CI 0.02-0.41).Conclusion There is a relatively high in-cidence rate of PSCI among patients with large-artery atherosclerotic cerebral infarction,and there is an"inverted V-shaped"non-linear relationship between SHR and the onset of PSCI.关键词
卒中后认知功能障碍/应激性高血糖比率/脑梗死/限制性三次样条分析Key words
Post-stroke cognitive impair-ment/Stress hyperglycemia ratio/Cerebral infarc-tion/Restricted cubic spline analysis分类
医药卫生引用本文复制引用
王鹤,殷煜,牛利,张明建,连航钺,张丽霞,安娜..应激性高血糖比率与大动脉粥样硬化型脑梗死患者卒中后认知功能障碍的相关性[J].中风与神经疾病杂志,2026,43(3):238-243,6.基金项目
北京京煤集团总医院科研基金(ZZ2024-45) （ZZ2024-45）
