Correlation Study Between Blood Glucose Level And Prognosis Of Acute Ischemic Stroke

Objective:This article aims to study the relationship,significance and assessed value of various blood glucose indexes such as fasting blood glucose,random blood glucose and glycosylated hemoglobin and the prognosis of acute ischemic stroke.Materials and Methods:Using retrospective analysis method,we screen and collect on 106 patients in neurology of Yanan university affiliated cardio-cerebrovascular hospital,with acute ischemic stroke,and had been confirmed by imageological examination,and come to the hospital within 24 hours,did not receive thrombolysis or arterial embolectomy and other special treatment,during November 10,2016 years to August 31,2017.Records the information of patients who conformed to the criteria.The informationg including patient's age,gender,BMI(body mass index),life habit,(smoking history,drinking history),hypertension history,diabetes history,time from onset to in hospital,NIHSS score on admission,random blood glucose,fasting glucose,glycosylated hemoglobin,hospital number and the contact details.Then follow-up visit them on 1 month,3 months and 6 months respectively after treatment,using outpatient service or telephone.Modified Rankin rating scale(mRS)as indicators of prognosis evaluation.According to mRS score results,prognosis can be divided into good prognosis group(mRS?2 points)and poor prognosis group(mRS>2 points),sorting data and compare the follow-up clinical data between different prognosis groups,on 1 month,3 months and 6 months.Find out the risk factors which affecting the prognosis,analysis the risk factors by Logistic regression to find the independent risk factors that caused of poor prognosis,analysis the correlation of glycemic and poor prognosis.Using ROC curve to analyze the remind value about random blood glucose,fasting blood glucose,glycosylated hemoglobin and the prognosis of patients whom with acute ischemic stroke.Results:106 patients were included in the standard,among which 71 were males(67%)and 35 females(33%).The good prognosis group has 50 cases(47.2%)and poor prognosis group has 56 cases(52.8%)in 1 month follow-up.Single factor analysis shows,the difference of age,NIHSS score,fasting blood glucose,onset time between the two groups was statistically significance(P<0.05).Multivariate analysis shows that the age,onset to admission time,NIHSS score were independent risk factor for the prognosis(short-term prognosis)of patients with acute cerebral infarction.There are 76 cases(71.7%)in good prognosis and 30 patients in poor prognosis(28.3%)on 3 month's follow-up visit.Single factor analysis showed that there has quiet differences on age,smoking history,history of hypertension,NIHSS score,random blood glucose,fasting glucose,glycosylated hemoglobin between the two groups,and the differences have a statistical significance(P<0.05).Multivariate analysis suggested: age,smoking,hypertension,NIHSS score,and fasting blood glucose were independent risk factors of poor prognosis in patients with acute cerebral infarction for 3 months.The fasting blood glucose have a high evaluation value to poor prognosis of 3 months in patients with acute ischemic stroke.There are 91 cases(85.8%)in good prognosis and 15 patients in poor prognosis(14.2%)on 6 month's follow-up visit.Single factor analysis show: age,hypertension disease history,diabetes history,NIHSS score,random blood glucose,fasting glucose,glycosylated hemoglobin between the two groups have significant difference,and the difference have a statistical significance(P<0.05).Multiple factors analysis show: age,hypertension history,diabetes history,NIHSS score on admission,random blood glucose,fasting glucose,glycosylated hemoglobin are both the independence risk factors of 6 months prognosis on acute ischemic stroke patients.Fasting blood glucose,random blood glucose and glycosylated hemoglobin both have good indication value for the long-term prognosis of acute ischemic stroke in 6 months,and the specificity of fasting blood glucose is the highest.Conclusions:(1)Age,time of onset to admission,NIHSS score on admission and fasting plasma glucose is the risk factor of acute ischemic stroke for 1 month short term prognosis.With age,onset time and NIHSS score is independent risk factor.(2)Age,smoking history,hypertension,NIHSS score,fasting glucose,random blood glucose,glycosylated hemoglobin is the risk factor of acute ischemic stroke for 3 month prognosis.And age,smoking history,history of hypertension,NIHSS score and fasting blood glucose are independent risk factors.(3)The value of evaluation on fasting blood glucose to 3 months prognosis of patients with acute ischemic stroke is high.(4)Age,history of hypertension,diabetes,NIHSS score on admission,fasting glucose,random blood glucose,glycosylated hemoglobin is the risk factor of acute ischemic stroke for 6 month long term prognosis.And age,history of hypertension,history of diabetes,NIHSS score on admission,fasting blood glucose,random blood glucose,and glycosylated hemoglobin are independent risk factors.(5)The value of evaluation on random blood glucose,fasting blood glucose and glycosylated hemoglobin to the 6 months prognosis of patients with acute ischemic stroke is high.Among them,the evaluation specificity of fasting blood glucose is the highest.