Relationship between glycosylated hemoglobin and hemorrhagic transformation after cerebral infarction
10.3760/cma.j.issn.1673-4904.2020.02.002
- VernacularTitle: 糖化血红蛋白与脑梗死后出血转化的关系研究
- Author:
Guanghui ZHANG
1
;
Zhenjie SUN
;
Mingli HE
;
Zhenwei GUO
;
Yongjin ZHANG
;
Na WANG
;
Niu JI
;
Fangrong WU
Author Information
1. Department of Neurology, Lianyungang Hospital Affiliated to Xuzhou Medical University, Jiangsu Lianyungang 222002, China
- Publication Type:Journal Article
- Keywords:
Cerebral infarction;
Hemorrhagic transformation;
Hemoglobin A1c;
Fasting blood glucose;
Outcome
- From:
Chinese Journal of Postgraduates of Medicine
2020;43(2):101-106
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the relationship between hemoglobin A1c (HbA1c) and hemorrhagic cerebral infarction (HI) in patients with acute cerebral infarction.
Methods:From January 2014 to June 2016, in the Lianyungang Hospital Affiliated to Xuzhou Medical University, 426 patients with acute anterior circulation infarction were included. The blood sugar status before stroke was expressed by HbA1c. HbA1c and fasting blood glucose (FBG) were measured on the second day after admission. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological function at admission. The modified Rankin scale (mRS) was used to evaluate the prognosis at discharge. CT or MRI/SWI examination was performed to determine whether there was HT. Logistic regression was used to evaluate the risk factors for HT and short-term prognosis after cerebral infarction.
Results:Of the 426 patients enrolled, 93 (21.8%) appeared HT, 60 (14.1%) had hemorrhagic cerebral infarction (HI) and 33 (7.7%) had parenchymal hemorrhage (PH). Multivariate analysis showed that HbA1c and infarct volume were independent predictor of HT. When patients were grouped according to fasting blood glucose (FBG<7.8 mmol/L or ≥ 7.8 mmol/L), the predictive effect of HbA1c on HT was found in both groups. In multiple Logistic regression analysis, HbA1c was also a predictor of poor prognosis after stroke (OR=1.482, 95% CI 1.228 -1.788).
Conclusions:In patients with ischemic stroke, elevated HbA1c is independently associated with post-infarction HT, and this result doesn′t change even in patients with well-controlled blood glucose. HbA1c is also a predictor of poor prognosis after stroke. These findings are important for blood glucose management in patients with diabetes and acute anterior circulation infarction.
