在急性缺血性中风中压力高血糖比率与严重意识障碍之间的非线性关联:MIMIC回顾分析
Zhangling Long1, Shuang Liao1, Ying Chen2
1Department of Neurology, Tongren City People's Hospital, Tongren, Guizhou, China.
PloS one
|August 21, 2025
概括
在急性缺血性中风患者中,高压高血糖比率 (SHR) 与严重的意识损伤 (格拉斯哥昏迷表 (GCS) ≤8) 和长期死亡率的增加有关. 这种关联,特别是GCS ≤8,显示出非线性关系.
科学领域:
- 神经学
- 内分泌学
- 危急护理医学
背景情况:
- 压力高血糖比率 (SHR) 是已知的标志物,但其在急性缺血性中风 (AIS) 中对严重意识损伤的预后价值尚未确立.
- 在AIS患者中,研究SHR与严重意识障碍 (格拉斯哥昏迷表 (GCS) ≤8) 和死亡率之间的关联对于临床治疗至关重要.
研究的目的:
- 在AIS患者中评估SHR和GCS≤8之间的关联.
- 确定SHR与AIS患者的长期死亡率之间的关系.
- 探索SHR与这些结果之间的潜在非线性关联.
主要方法:
- 使用MIMIC数据库进行回顾性队列研究.
- 使用Cox比例风险和限制立方线 (RCS) 模型来分析SHR与结果之间的关系.
- 用卡普兰 - 梅尔曲线来比较不同SHR水平的结果.
主要成果:
- 长期死亡率为28. 75%.
- 增加的SHR与GCS≤8 (HR=1.52) 和长期死亡率 (HR=1.32) 显著相关.
- 在SHR和GCS≤8之间观察到显著的非线性关系,而与死亡率的关系大约是线性的. 在高SHR群体中,卡普兰-梅尔曲线证实了更高的事件率.
结论:
- 在AIS患者中,SHR升高与严重的意识障碍和长期死亡率的增加独立相关.
- SHR和GCS ≤ 8之间的关系是非线性的,表明复杂的病理生理相互作用.
- 需要进一步的研究来验证这些发现并探索临床影响.
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