Diabetes mellitus inhibits complete recanalization in patients with middle cerebral artery occlusion

被引:2
作者
Aoki, Junya [1 ]
Kimura, Kazumi [1 ]
Morita, Naomi [2 ]
Harada, Masafumi [3 ]
Nagahiro, Shinji [4 ]
机构
[1] Nippon Med Sch, Dept Neurol Sci, Grad Sch Med, Tokyo, Japan
[2] Iseikai Hosp, Dept Radiol, Osaka, Japan
[3] Tokushima Univ, Dept Radiol, Inst Biomed Sci, Tokushima, Japan
[4] Tokushima Univ, Tokushima Univ Hosp, Tokushima, Japan
关键词
Diabetes mellitus; intravenous thrombolysis; recanalization; middle cerebral artery occlusion; clinical outcome; ACUTE ISCHEMIC-STROKE; TISSUE-PLASMINOGEN ACTIVATOR; INTRAVENOUS ALTEPLASE; THROMBOLYSIS; OUTCOMES; THERAPY; GLUCOSE;
D O I
10.1080/01616412.2018.1531201
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Methods: This was a retrospective cohort study. Data from 165 patients, with middle cerebral occlusion before t-PA therapy (from the YAMATO study databank), were retrospectively evaluated. Patients were classified into diabetic (D) or non-diabetic (ND) groups based on the history of diabetes mellitus (DM) or hemoglobin A1c levels of >= 6.5%. Arterial recanalization was assessed using magnetic resonance angiography or digital subtraction angiography at 2 points: 1) early recanalization, within 2 h; 2) delayed complete recanalization at 24 h. Good clinical outcome was defined as modified Rankin Scale score 0-2 at 3 months. Results: A total of 33 (21%) were classified into the D and 127 (79%) in the ND groups. Early recanalization was similarly in the D and ND groups (61% vs. 52%, p = 0.434). However, complete recanalization at 24 h was infrequent in the D group (13% vs. 43%, p = 0.002). Among patients with early recanalization, 4 (22%) of 18 patients in the D group and 32 (56%) of 57 patients in the ND group had complete recanalization at 24 h (p = 0.015); while among those without early recanalization, 17 (30%) in the ND and none in the D groups had complete recanalization at 24 h (p = 0.028). Multivariate regression analysis showed DM was one of the independent negative factors for complete recanalization at 24 h (odds ratio 0.113, 95%CI: 0.027-0.472, p = 0.003). At 3 months, group with complete recanalization at 24 h achieved higher frequency of good outcome (67% vs. 49%, p = 0.046). Conclusion: Diabetes might be a risk factor of incomplete recanalization at 24 h regardless of early recanalization.
引用
收藏
页码:60 / 67
页数:8
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