Relationship between elevated fibrinogen and early neurological deterioration in type 2 diabetes mellitus patients with acute cerebral infarction / 中华老年医学杂志

ABSTRACT

Objective:To investigate the relationship between plasma fibrinogen(FIB) levels and early neurological deterioration(END) in elderly patients with type 2 diabetes mellitus(DM) after acute cerebral infarction(ACI).Methods:136 ACI patients admitted to the neurology department of our hospital from January 2018 to December 2019 were included as study subjects.Patients were divided into an END group and a non-END group based on whether END occurred.Univariate and multivariate analyses were conducted to assess the relationship between FIB and END.Elderly patients with concurrent ACI and DM were divided into an END group(18 cases)and a non-END group(26 cases)for propensity score matching analysis.After matching adjustment, age, sex, hypertension, TOAST classification and FIB were analyzed by multivariate Logistic regression.Results:Among 136 patients with ACI, 38(27.9%)had END and 98(72.1%)did not have END and the END group had higher values or percentages than the non-END group in age[(62.3±2.4)ys and(59.2±1.8)ys, t=2.035, P=0.044], history of hypertension(76.3% and 57.1%, χ2=4.295, P=0.038), history of diabetes(47.4% and 26.5%, χ2=5.433, P=0.020), NIHSS score[(8.5±5.7)and(6.1±4.6), t=2.548, P=0.012], TOAST classification(large artery atherosclerosis 65.8% vs.40.8%, cardioembolism 5.3% vs.10.2%, small artery occlusion 23.7% vs.23.5%, other determined cause 2.6% vs.20.4%, undetermined cause 2.6% vs.5.1%, χ2=10.314, P=0.035), blood glucose[(8.89±1.28)mmol/L and(7.36±1.64)mmol/L, t=6.048, P=0.000]and FIB level[(3.57±1.33)g/L and(3.07±1.14)g/L, t=2.236, P=0.027]. Multiple regression analysis showed that higher FIB levels were not associated with END( P>0.05). Propensity score matching analysis of 44 patients with concurrent ACI and DM showed that history of hypertension, NIHSS score and FIB level before matching were significantly higher in the END group than in the non-END group( P<0.05)and FIB was higher in the END group than in the non-END group after matching.Multiple regression analysis showed that FIB was significantly associated with END. Conclusions:Increased FIB levels are positively correlated with END in patients with diabetes following acute ischemic stroke and possess good predictive value.