急性缺血性脑卒中静脉溶栓患者血糖及糖化血红蛋白与预后相关性的研究进展
Research Progress of Correlation between Blood Glucose and Glycosylated Hemoglobin and Prognosis of AIS Intravenous Thrombolysis
摘要: 急性缺血性脑卒中(AIS)是指脑血供突然中断后导致的脑组织坏死，而出现相应神经功能缺损的一类临床综合征。静脉溶栓治疗超早期急性缺血性脑卒中是目前普遍认可的有效治疗方案。大量研究已证实糖尿病是急性缺血性卒中的独立危险因素。有研究证明无论是糖尿病造成的高血糖还是应激性高血糖或者糖化血红蛋白、血糖变异性的升高都是AIS患者静脉溶栓后早期神经功能恶化、出血转化、不良预后的独立预测因素。本文就血糖及糖化血红蛋白与AIS静脉溶栓患者预后、早期神经功能恶化和SICH的关系以及可能机制进行综述。
Abstract: Acute ischemic stroke (AIS) is a clinical syndrome that cerebral tissue is necrotic due to sudden interruption of cerebral blood supply, resulting in neurological deficits. At present, intravenous thrombolysis is an effective treatment in ultra-early acute ischemic stroke. A large number of studies have confirmed that diabetes is an independent risk factor of acute ischemic stroke. Some studies have shown that hyperglycemia caused by diabetes, stress hyperglycemia, increasing glycosylated hemoglobin, and glucose variability are independent predictors of early neurological deterioration, hemorrhagic transformation and poor prognosis after AIS intravenous thrombolysis. This article reviews the relationship and the possible mechanisms between blood glucose and glycated hemoglobin and the prognosis, early neurological deterioration and SICH of AIS intravenous thrombolysis.
文章引用：王强, 薛艺东. 急性缺血性脑卒中静脉溶栓患者血糖及糖化血红蛋白与预后相关性的研究进展[J]. 临床医学进展, 2022, 12(3): 1594-1598. https://doi.org/10.12677/ACM.2022.123229

参考文献

[1] 王陇德, 刘建民, 杨弋, 等. 我国脑卒中防治仍面临巨大挑战——《中国脑卒中防治报告2018》概要[J]. 中国循环杂志, 2019, 34(2): 105-119.
[2] Sledzińska-Dźwigał, M., Sobolewski, P. and Szczuchniak, W. (2013) Factors Affecting the Occurrence of Symptomatic Intracerebral Haemorrhage after Intravenous Thrombolysis Depending on the Haemorrhage Definition. Neurologia I Neurochirurgia Polska, 47, 405-413. [Google Scholar] [CrossRef] [PubMed]
[3] Osei, E., Fonville, S., Zandbergen, A.A.M., et al. (2018) Impaired Fasting Glucose Is Associated with Unfavorable Outcome in Ischemic Stroke Patients Treated with Intravenous Alteplase. Journal of Neurology, 265, 1426-1431. [Google Scholar] [CrossRef] [PubMed]
[4] Capes, S.E., Hunt, D., Malmberg, K., et al. (2001) Stress Hyperglycemia and Prognosis of Stroke in Nondiabetic and Diabetic Patients: A Systematic Overview. Stroke, 32, 2426-2432. [Google Scholar] [CrossRef] [PubMed]
[5] 李弘, 石秋艳, 张春阳, 等. 血糖及血糖变异性对急性缺血性脑卒中静脉溶栓预后的影响[J]. 中华老年心脑血管病杂志, 2016, 18(5): 518-521.
[6] 陈秋月, 张丹红, 张仙飞, 等. 血糖及其变异性与急性大面积脑梗死预后的相关性[J]. 中华危重病急救医学, 2013, 25(12): 749-753.
[7] Bi, J., Song, L., Wang, L., et al. (2021) Visit-to-Visit Fasting Blood Glucose Variability and Lifetime Risk of Cardiovascular Disease: A Prospective Study. Cardiovascular Diabetology, 20, 207. [Google Scholar] [CrossRef] [PubMed]
[8] 王少岩, 张淑芬, 王美琳, 等. 中性粒细胞在急性缺血性卒中病程中的作用及研究进展[J]. 中国脑血管病杂志, 2021, 18(6): 423-427.
[9] Tsivgoulis, G., Katsanos, A.H., Mavridis, D., et al. (2019) Association of Baseline Hyperglycemia with Outcomes of Patients with and without Diabetes with Acute Ischemic Stroke Treated with Intravenous Thrombolysis: A Propensity Score-Matched Analysis from the SITS-ISTR Registry. Diabetes, 68, 1861-1869. [Google Scholar] [CrossRef] [PubMed]
[10] Putaala, J., Sairanen, T., Meretoja, A., et al. (2011) Post-Thrombolytic Hyperglycemia and 3-Month Outcome in Acute Ischemic Stroke. Cerebrovascular Diseases (Basel, Switzerland), 31, 83-92. [Google Scholar] [CrossRef] [PubMed]
[11] Desilles, J.P., Meseguer, E., Labreuche, J., et al. (2013) Diabetes Mellitus, Admission Glucose, and Outcomes after Stroke Thrombolysis: A Registry and Systematic Review. Stroke, 44, 1915-1923. [Google Scholar] [CrossRef] 
[12] Saqqur, M., Shuaib, A., Alexandrov, A.V., et al. (2015) The Correlation between Admission Blood Glucose and Intravenous rt-PA-Induced Arterial Recanalization in Acute Ischemic Stroke: A Multi-Centre TCD Study. International Journal of Stroke: Official Journal of the International Stroke Society, 10, 1087-1092. [Google Scholar] [CrossRef] [PubMed]
[13] Cao, W., Ling, Y., Wu, F., et al. (2015) Higher Fasting Glucose Next Day after Intravenous Thrombolysis Is Independently Associated with Poor Outcome in Acute Ischemic Stroke. Journal of Stroke and Cerebrovascular Diseases: The Official Journal of National Stroke Association, 24, 100-103. [Google Scholar] [CrossRef] [PubMed]
[14] Ahmed, N., Dávalos, A., Eriksson, N., et al. (2010) Association of Admission Blood Glucose and Outcome in Patients Treated with Intravenous Thrombolysis: Results from the Safe Implementation of Treatments in Stroke International Stroke Thrombolysis Register (SITS-ISTR). Archives of Neurology, 67, 1123-1130. [Google Scholar] [CrossRef] [PubMed]
[15] 黄镪, 马青峰, 宋海庆, 等. 血糖对急性缺血性卒中静脉溶栓治疗后结局的影响[J]. 首都医科大学学报, 2017, 38(1): 53-58.
[16] Filipov, A., Ebert, A.D., Neumaier-Probst, E., et al. (2018) The Burden of Diabetes and the Chance of a Previous Stroke: Thrombolysis for Recurrent Stroke in Diabetics. Journal of Stroke and Cerebrovascular Diseases: The Official Journal of National Stroke Association, 27, 1343-1349. [Google Scholar] [CrossRef] [PubMed]
[17] 苏量. 脑梗死早期神经功能恶化的临床特征及与血清糖化血红蛋白的相关性分析[J]. 神经损伤与功能重建, 2017, 12(4): 354-355, 363.
[18] Rocco, A., Heuschmann, P.U., Schellinger, P.D., et al. (2013) Glycosylated Hemoglobin A1 Predicts Risk for Symptomatic Hemorrhage after Thrombolysis for Acute Stroke. Stroke, 44, 2134-2138. [Google Scholar] [CrossRef] 
[19] Zhu, B., Yan, L., Ren, H., et al. (2021) Predictive Value of Apelin and Vaspin on Hemorrhagic Transformation in Patients with Acute Ischemic Stroke after Intravenous Thrombolysis and Analysis of Related Factors. Evidence-Based Complementary and Alternative Medicine: Ecam, 2021, Article ID: 5020622. [Google Scholar] [CrossRef] [PubMed]

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