ICH-FOS量表及糖基化指数评估脑出血后1年预后效果(1)
【摘要】 目的 探讨脑出血功能预后评分(ICH-FOS)量表及糖基化指数(HGI)对脑出血后1年预后情况的指导价值。方法 对188例脑出血患者进行ICH-FOS量表评价，并根据空腹血糖及GHbA1c计算HGI，按HGI将患者分为低HGI、中HGI及高HGI组。在患者发病后1年进行随访，采用多因素分析HGI结合ICH-FOS量表对评价患者1年预后的效果。结果 188例中预后不良共93例，随着ICH-FOS分值增加，预后不良比例也增高;中HGI组血糖偏低，与高HGI组间存在差异[(6.2±1.85) mmol/L vs. (8.0±3.11) mmol/L，P = 0.003];低、中、高HGI组的GHbA1c逐渐增大[6.2% vs. 6.9% vs. 9.3%]，差异有统计学意义(P < 0.05)。多因素分析显示，ICH-FOS量表中的各项及HGI均与脑出血1年的预后相关(P均< 0.05)。结论 ICH-FOS量表及HGI有助于指导临床医师评估脑出血患者的预后。
【关键词】 脑出血; 糖化血红蛋白A1c;糖基化指数;脑出血功能预后评分量表
Prognostic value of hemoglobin glycation index and ICH-FOS scale for 1-year outcomes after spontaneous intracerebral hemorrhage Wang Pingli， Wang Yongsheng， Wu Zhipeng. Department of Neuro-logy， Wenzhou City Hospital of Integrated Traditional Chinese and Western Medicine， Wenzhou 325000， China
Corresponding author， Wang Pingli， E-mail： pingliw@ 126. com
【Abstract】 Objective To evaluate the guidance value of hemoglobin glycation index (HGI) and ICH-FOS scale in predicting the 1-year clinical prognosis after spontaneous intracerebral hemorrhage (ICH). Methods A total of 188 patients with ICH were evaluated by ICH-FOS scale. HGI was calculated by subtracting the predicted HbA1c based on fasting plasma glucose from the observed GHbA1c. All patients were classified into the low-， moderate-and high-HGI groups. All patients were subject to follow-up at 1 year after sICH onset. The values of HGI and ICH-FOS scale in predicting the 1-year clinical prognosis after ICH were evaluated by multivariate analysis. Results Among 188 ICH patients， 93 patients obtained poor outcomes. The percentage of patients with poor prognosis was increased with the increasing ICH-FOS score. The blood glucose level in the moderate-HGI group was significantly lower than that in the high-HGI group [(6.2±1.85) vs. (8.0±3.11) mmol/L， P = 0.003). The GHbA1c levels were gradually increased among the three groups (6.2% vs. 6.9% vs.9.3%). Multivariate analysis demonstrated that HGI and each parameter of the ICH-FOS scale were significantly associated with 1-year clinical prognosis after sICH (all P < 0.05). Conclusion Both ICH-FOS scale and HGI can provide guidance on evaluating the 1-year clinical prognosis of sICH patients.
【Key words】 Spontaneous intracerebral hemorrhage;Glycosylated hemoglobin A1c;
Hemoglobin glycation index;ICH-FOS scale
自發性脑出血(ICH)病死率及残疾率高，预后不佳，既往研究显示高血糖与脑出血后神经功能恢复不良相关，但强化降糖治疗并没有改善脑出血的预后[1-3]。因此研究者们推测1次的血糖水平可能不是理想的预测脑出血预后的指标。GHbA1c水平反映了机体既往2 ～ 3个月血糖的平均水平，糖基化指数(HGI)量化了患者GHbA1c观察值和预测值之间的差异大小和差异方向[4]。脑出血功能预后评分(ICH-FOS)量表在预测脑出血的短期、中期及长期预后方面具有明显的优势[5]。在本研究中，笔者联合使用HGI与ICH-FOS量表评估脑出血后1年患者的预后情况，现将结果报告如下。, 百拇医药(王苹莉?王永盛?吴志鹏)
【关键词】 脑出血; 糖化血红蛋白A1c;糖基化指数;脑出血功能预后评分量表
Prognostic value of hemoglobin glycation index and ICH-FOS scale for 1-year outcomes after spontaneous intracerebral hemorrhage Wang Pingli， Wang Yongsheng， Wu Zhipeng. Department of Neuro-logy， Wenzhou City Hospital of Integrated Traditional Chinese and Western Medicine， Wenzhou 325000， China
Corresponding author， Wang Pingli， E-mail： pingliw@ 126. com
【Abstract】 Objective To evaluate the guidance value of hemoglobin glycation index (HGI) and ICH-FOS scale in predicting the 1-year clinical prognosis after spontaneous intracerebral hemorrhage (ICH). Methods A total of 188 patients with ICH were evaluated by ICH-FOS scale. HGI was calculated by subtracting the predicted HbA1c based on fasting plasma glucose from the observed GHbA1c. All patients were classified into the low-， moderate-and high-HGI groups. All patients were subject to follow-up at 1 year after sICH onset. The values of HGI and ICH-FOS scale in predicting the 1-year clinical prognosis after ICH were evaluated by multivariate analysis. Results Among 188 ICH patients， 93 patients obtained poor outcomes. The percentage of patients with poor prognosis was increased with the increasing ICH-FOS score. The blood glucose level in the moderate-HGI group was significantly lower than that in the high-HGI group [(6.2±1.85) vs. (8.0±3.11) mmol/L， P = 0.003). The GHbA1c levels were gradually increased among the three groups (6.2% vs. 6.9% vs.9.3%). Multivariate analysis demonstrated that HGI and each parameter of the ICH-FOS scale were significantly associated with 1-year clinical prognosis after sICH (all P < 0.05). Conclusion Both ICH-FOS scale and HGI can provide guidance on evaluating the 1-year clinical prognosis of sICH patients.
【Key words】 Spontaneous intracerebral hemorrhage;Glycosylated hemoglobin A1c;
Hemoglobin glycation index;ICH-FOS scale
自發性脑出血(ICH)病死率及残疾率高，预后不佳，既往研究显示高血糖与脑出血后神经功能恢复不良相关，但强化降糖治疗并没有改善脑出血的预后[1-3]。因此研究者们推测1次的血糖水平可能不是理想的预测脑出血预后的指标。GHbA1c水平反映了机体既往2 ～ 3个月血糖的平均水平，糖基化指数(HGI)量化了患者GHbA1c观察值和预测值之间的差异大小和差异方向[4]。脑出血功能预后评分(ICH-FOS)量表在预测脑出血的短期、中期及长期预后方面具有明显的优势[5]。在本研究中，笔者联合使用HGI与ICH-FOS量表评估脑出血后1年患者的预后情况，现将结果报告如下。, 百拇医药(王苹莉?王永盛?吴志鹏)