高血糖症不会改变在晚期时间窗口 (6-24小时) 内血管治疗的疗效
Clemens Jba Kersten1, Adrienne Am Zandbergen2, Susanne Gh Olthuis3,4
1Department of Neurology, Isala Zwolle, Zwolle, The Netherlands.
概括
入院葡萄糖水平和高血糖症不会影响晚期缺血性中风患者的内血管治疗 (EVT) 结果. 这项研究没有发现有证据表明血糖会改变前部循环中风治疗的疗效,治疗时间为6-24小时.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 高血糖是患有缺血性中风的患者的常见并发症.
- 已经证明,摄入葡萄糖水平会影响内血管治疗 (EVT) 在早期窗口缺血性中风治疗 (0-6小时) 的有效性.
- 摄入葡萄糖在晚期治疗窗口 (6-24小时) 上对EVT的影响尚不清楚.
研究的目的:
- 调查是否入院葡萄糖水平或高血糖会改变在晚期时间窗口 (6-24小时) 中前部循环缺血性中风患者的EVT的有效性.
主要方法:
- 利用了MR CLEAN LATE试验中的数据.
- 评估了90天后修改的兰金表 (mRS) 评分的主要结果.
- 通过使用逻辑回归来分析葡萄糖或高血糖对治疗效果的改变,并对混因素进行调整. 高血糖症被定义为葡萄糖>7.8 mmol/L.
主要成果:
- 摄入血糖的中位数为7.0mmol/L,32%的患者呈现高血糖症.
- 在高血糖或葡萄糖水平和EVT治疗对功能结果的影响之间没有发现显著的相互作用 (p=0.76和p=0.79).
- 对症状性内出血 (高血糖p=0.29,葡萄糖p=0.57) 或死亡率 (高血糖p=0.52,葡萄糖p=0.69) 没有观察到相互作用.
结论:
- 这项研究没有发现任何证据表明,入院葡萄糖水平或高血糖会改变急性缺血性中风患者的EVT有效性,这些患者在晚期治疗窗口内在前部循环中出现大血管封闭.
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