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| 三酰甘油-葡萄糖指数对急性轻型缺血性脑卒中溶栓后早期神经功能恶化的预测价值 |
| The predictive value of the triglyceride-glucose index for early neurological deterioration after thrombolysis in acute minor ischemic stroke |
| 投稿时间：2025-05-16 |
| DOI：10.3969/j.issn.1000-0399.2026.03.002 |
| 中文关键词: 三酰甘油-葡萄糖指数 早期神经功能恶化 急性轻型缺血性卒中 静脉溶栓 |
| 英文关键词: Triglyceride-glucose index Early neurological deterioration Minor ischemic stroke Intravenous thrombolysis |
| 基金项目:安徽省教育厅高校科学研究项目(编号:2022AH051401); 阜阳市卫生健康科研项目(编号:FYZC2024-072) |
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| 中文摘要: |
| 目的 探讨三酰甘油-葡萄糖（TyG）指数对接受阿替普酶静脉溶栓治疗的急性轻型缺血性卒中（MIS）患者出现早期神经功能恶化（END）的预测价值。方法 回顾性分析2022年3月至2025年2月在临泉县人民医院住院，且使用阿替普酶溶栓治疗的328例MIS患者临床资料。根据公式计算TyG指数。根据患者入院3 d内美国国立卫生研究院卒中量表（NIHSS）评分分为END组（82例）和非END组（246例），采用二元多因素logistic回归分析评估END的危险因素，再使用受试者工作特征（ROC）曲线分析危险因素对END的预测价值。结果 多因素二元logistic回归分析显示，TyG指数（OR=2.910,95%CI:1.588～5.331,P=0.001）是MIS患者静脉溶栓治疗后发生END的独立危险因素，同时发现溶栓后即刻NIHSS评分（OR=1.241,95%CI:1.063～1.448,P=0.006）及梗死模式也是这类患者的危险因素；在梗死模式方面，与无梗死灶（参照）相比，单个梗死灶（OR=4.842,95%CI:1.893～12.384,P=0.001）、多发梗死灶（OR=4.626,95%CI:1.728～12.382,P=0.002）和分水岭梗死（OR=17.535,95%CI:3.266～94.131,P=0.001）均增加END风险。ROC曲线分析显示，TyG指数预测END的最佳截断值是8.67，曲线下面积（AUC）为0.671，联合溶栓后即刻NIHSS指标，AUC提升至0.706。结论 TyG指数是接受溶栓治疗的MIS患者发生END的独立危险因素，单独TyG指数有一定的预测价值，联合临床指标能够提升对END的预测效能。 |
| 英文摘要: |
| Objective To investigate the predictive value of the triglyceride-glucose index(TyG) for early neurological deterioration(END) in patients with acute minor ischemic stroke(MIS) treated with intravenous alteplase thrombolysis. Methods A retrospective analysis was conducted on clinical data from 328 MIS patients who received alteplase thrombolysis in our hospital from March 2022 to February 2025. The TyG index was calculated using the standard formula. Patients were divided into the END group(82 cases) and the non-END group(246 cases) based on whether National Institutes of Health Stroke Scale(NIHSS) scores progressed within 72 hours of admission. Binary multivariate logistic regression analysis was used to evaluate the risk factors for END, and receiver operating characteristic(ROC) curve analysis was employed to assess the predictive value of these risk factors. Results Multivariate binary logistic regression analysis revealed that the TyG index was an independent risk factor for END after intravenous thrombolysis in MIS patients(OR=2.910,95% CI: 1.588～5.331, P=0.001). Additionally, immediate post-thrombolysis NIHSS scores(OR=1.241,95%CI:1.063～1.448,P=0.006)and infarction patterns were also identified as risk factors.Regarding infarction pattern, compared to no infarction lesions(reference), single infarction lesion(OR=4.842, 95% CI:1.893～12.384, P=0.001), multiple infarction lesions(OR=4.626, 95% CI: 1.728～12.382, P=0.002), and watershed infarction(OR=17.535, 95% CI: 3.266～94.131, P=0.001) were all significantly associated with an increased risk of END.The ROC curve analysis demonstrated that the TyG index predicted END with an optimal cut-off value of 8.67 and an AUC of 0.671, whereas the predictive performance improved to an AUC of 0.706 after incorporating the immediate NIHSS score post-thrombolysis. Conclusion The TyG index is an independent risk factor for END in MIS patients treated with thrombolysis. While the TyG index alone has moderate predictive value, its combination with clinical indicator significantly enhances the predictive performance for END. |
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