高血糖症与计算机断层扫描有关 输液核心体积低估 在急性缺血性中风患者中与大血管闭塞相关的患者中
Arash Niktabe1, Juan Carlos Martinez-Gutierrez2, Sergio Salazar-Marioni1
1Department of Neurology, UTHealth McGovern Medical School, Houston, Texas.
Stroke (Hoboken, N.J.)
|October 10, 2024
概括
无论是急性还是慢性,高血糖都与CT perfusion (CTP) 中心脏病核心预测在急性缺血性中风 (AIS) 患者中的低估有关. 这凸显了在解释CTP结果时考虑血糖水平的重要性.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 血管内治疗疗法 血管内疗法
背景情况:
- 在大血管封闭 (LVO) 急性缺血性中风 (AIS) 中,CT输液 (CTP) 对于确定治疗资格至关重要.
- 已知血糖水平会影响大脑血流 (CBF).
- 这项研究调查了急性和慢性高血糖症对心脏病发作核心体积CTP估计的影响.
研究的目的:
- 检查急性和慢性高血糖之间的关联以及CTP衍生的心脏病核心体积估计在LVO AIS患者的准确性.
- 为了确定血糖和HbA1c水平的升高是否与CTP低估或高估心脏病核心体积相关.
- 评估血糖状况对CTP解释对内血管治疗决策的临床影响.
主要方法:
- 对前性收集的LVO AIS患者多中心观察队列的分析.
- 纳入标准:CTP与RAPID后处理,内血管治疗与TICI 2b-3再输在90分钟内,和最终的心脏病体积 (FIV) 通过MRI在48-72小时.
- 主要结局:呈现葡萄糖和HgbA1c与心脏病核心低估 (UE) 的关联,使用多变量逻辑回归.
- 二级结果:心脏病发作频率核心高估 (OE).
主要成果:
- 包括256名患者;51.6%的葡萄糖升高,36.3%的HgbA1c升高.
- 中位数CTP预测核心:6毫升;中位数FIV:14毫升;中位数差异:12毫升.
- 低估 (UE) 发生在26.6%的患者中,高估 (OE) 发生在10.9%的患者中.
- UE独立地与葡萄糖 (aOR 2.10) 和HgbA1c (aOR 2.37) 的升高有关.
- OE与表现较低的血糖和HgbA1c.c.相关.
结论:
- 急性和慢性高血糖症与在接受EVT的LVO AIS患者中CTP低估心脏病核心显著相关.
- 血糖状况是解释AIS患者中CTP发现的一个重要因素.
- 这些发现可能会影响治疗决策和患者的治疗结果.
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