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| 甘油三酯-葡萄糖指数与前循环大血管闭塞急性缺血性脑卒中的关系 |
| 蔺茹月1,2△,范建强2,3△,王丽君2,张小曦2,沈红健2,邢鹏飞2,张磊2,李子付2,张永巍2,杨鹏飞2,刘建民2,赵瑞2* |
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(1. 上海理工大学健康科学与工程学院, 上海 200093;
2. 海军军医大学(第二军医大学)第一附属医院脑血管病中心, 上海 200433;
3. 上海中冶医院神经内科, 上海 200941
△共同第一作者
*通信作者) |
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| 摘要: |
| 目的 探讨甘油三酯-葡萄糖指数（TyG）与前循环大血管闭塞急性缺血性脑卒中（AIS-LVO）的关系。方法 回顾性分析2018年1月至2019年12月在海军军医大学第一附属医院脑血管病中心行急诊血管内取栓治疗的前循环AIS-LVO患者的资料。根据术后90 d改良Rankin量表（mRS）评分将所有患者分为预后良好组（mRS评分为0～2分）和预后不良组（mRS评分为3～6分），比较两组患者的TyG。再根据TyG中位数将患者分为低TyG组（TyG＜8.57）和高TyG组（TyG≥8.57），比较两组患者的临床资料、实验室指标及影像学特征。通过ROC曲线评价TyG对预后不良的预测价值。结果 共纳入135例患者，其中预后良好组72例，预后不良组63例，预后不良组的TyG高于预后良好组（8.82±0.63 vs 8.43±0.60，P＜0.001）。低TyG组67例、高TyG组68例；与低TyG组相比，高TyG组有高脂血症病史的患者比例（P＝0.003）、入院时收缩压（P＝0.018）、空腹血糖水平（P＜0.001）、甘油三酯水平（P＜0.001）均更高，核心梗死体积更大（P＝0.025），高密度脂蛋白胆固醇水平更低（P＝0.013），术后90 d mRS评分也更高［3（1，5）分vs 1（0，5）分，P＝0.049］。TyG对前循环AIS-LVO患者预后不良有一定的预测价值（AUC值为0.662，95% CI 0.571～0.753）。结论 TyG在预后不良的前循环AIS-LVO患者中升高，可能是前循环AIS-LVO患者的潜在预后指标。 |
| 关键词: 急性缺血性脑卒中 甘油三酯-葡萄糖指数 前循环大血管闭塞 血管内治疗 |
| DOI：10.16781/j.CN31-2187/R.20250055 |
| 投稿时间：2025-01-27修订日期：2025-03-10 |
| 基金项目:中华国际医学交流基金会脑血管病青年创新基金（Z-2016-20-2201），海军军医大学校级基础医学研究课题（2023QN051）. |
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| Relationship between triglyceride-glucose index and acute ischemic stroke with anterior circulation large vessel occlusion |
| LIN Ruyue1,2△,FAN Jianqiang2,3△,WANG Lijun2,ZHANG Xiaoxi2,SHEN Hongjian2,XING Pengfei2,ZHANG Lei2,LI Zifu2,ZHANG Yongwei2,YANG Pengfei2,LIU Jianmin2,ZHAO Rui2* |
(1. School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China;
2. Neurovascular Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
3. Department of Neurology, Shanghai Zhongye Hospital, Shanghai 200941, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To explore the relationship between triglyceride-glucose index (TyG) and acute ischemic stroke with large vessel occlusion (AIS-LVO) of anterior circulation. Methods A retrospective study was conducted on patients with anterior circulation AIS-LVO who underwent emergency endovascular thrombectomy at Neurovascular Center of The First Affiliated Hospital of Naval Medical University from Jan. 2018 to Dec. 2019. According to modified Rankin scale (mRS) score 90 d after operation, the patients were assigned to favorable outcome group (mRS score 0-2) or unfavorable outcome group (mRS score 3-6), and the TyG was compared. According to the median of TyG, the patients were assigned to low-TyG group (TyG＜ 8.57) or high-TyG group (TyG≥8.57), and the clinical data, laboratory indexes, and imaging characteristics were compared. Receiver operating characteristic curve was used to evaluate the predictive value of TyG for poor prognosis. Results A total of 135 patients were enrolled, with 72 in the favorable outcome group and 63 in the unfavorable outcome group. The TyG of the unfavorable outcome group was significantly higher than that of the favorable outcome group (8.82±0.63 vs 8.43±0.60, P＜0.001). There were 67 patients in the low-TyG group and 68 in the high-TyG group. Compared with the low-TyG group, the proportion of patients with hyperlipidemia history (P＝0.003), systolic blood pressure at admission (P＝0.018), fasting blood glucose level (P＜0.001), and triglyceride level (P＜0.001) were significantly higher in the high-TyG group, the infarct core volume was significantly larger (P＝0.025), the high density lipoprotein-cholesterol level was significantly lower (P＝0.013), and the mRS score 90 d after operation was significantly higher (3 ［1, 5］ vs 1 ［0, 5］, P＝0.049). The TyG had certain predictive value for poor prognosis in anterior circulation AIS-LVO patients (area under curve value＝0.662, 95% confidence interval 0.571-0.753). Conclusion TyG is elevated in anterior circulation AIS-LVO patients with poor prognosis, and may be a potential prognostic indicator for anterior circulation AIS-LVO patients. |
| Key words: acute ischemic stroke triglyceride-glucose index anterior circulation large vessel occlusion endovascular therapy |
