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Neurology:急性缺血性脑卒中患者入院高血糖可以预测脑卒中后感染!

2017-03-11 xing.T MedSci原创

由此可见,在非糖尿病急性缺血性脑卒中患者中,入院高血糖与脑卒中后感染与预后较差相关。脑卒中后感染并没有改变入院高血糖对缺血性脑卒中患者功能预后的影响。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在探讨入院时高血糖是否可以预测卒中后感染,如果是的话,卒中后感染是否会改变入院时高血糖对缺血性脑卒中患者功能预后的影响。

研究人员使用的数据来自于卒中预防性抗生素使用研究(PASS)的急性缺血性卒中患者,PASS研究是一项多中心随机对照试验(n=2550)以调查预防性抗生素使用对功能预后的影响。入院时高血糖是指血液中的葡萄糖≥7.8mmol/L,卒中后感染是指住院期间的任何由专家委员会判定的感染。3个月时的功能结局采用改良Rankin量表来进行评估。

在1676例缺血性脑卒中患者中,338例(20%)患者存在入院时高血糖。调整潜在的混杂变量后,入院高血糖与脑卒中后感染(调整后的比值比[aOR]为2.31,95%可信区间[CI]为1.31-4.07)、3个月功能结局较差(aOR为1.40,95%CI为1.12-1.73)和3个月的死亡率(aOR为2.11,95%CI为1.40-3.19)有关。在功能结局分析中额外对卒中后感染进行调整,评估脑卒中后感染作为入院高血糖与功能结局的一个中间的通路,并没有实质性地改变模型。在糖尿病患者(n=418),入院高血糖与脑卒中后感染无关(aOR为0.49,95%CI为0.15-1.58)。

由此可见,在非糖尿病急性缺血性脑卒中患者中,入院高血糖与脑卒中后感染以及预后较差相关。脑卒中后感染并没有改变入院高血糖对缺血性脑卒中患者功能预后的影响。

原始出处:

Thomas P. Zonneveld, et al. Hyperglycemia predicts poststroke infections in acute ischemic stroke.Neurology.2017. http://www.neurology.org/content/early/2017/03/10/WNL.0000000000003811.abstract

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style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Nov 05 00:32:00 CST 2017, time=2017-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999841, encodeId=09011999841ad, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Oct 21 14:32:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), 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encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 13 06:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261101, encodeId=39a41261101a6, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Mon Mar 13 06:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=)]
  5. 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style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Nov 05 00:32:00 CST 2017, time=2017-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999841, encodeId=09011999841ad, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Oct 21 14:32:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), 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encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 13 06:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261101, encodeId=39a41261101a6, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Mon Mar 13 06:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=)]
    2017-10-21 yinhl1978
  6. 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  7. 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encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 13 06:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261101, encodeId=39a41261101a6, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Mon Mar 13 06:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=)]
    2017-03-18 ylzr123

    认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。

    0

  8. 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encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 13 06:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261101, encodeId=39a41261101a6, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Mon Mar 13 06:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=)]
    2017-03-14 天涯183

    非常好的文章

    0

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    2017-03-13 hbwxf

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