代谢综合征与非心脏手术围手术期缺血性卒中风险：一项病例对照回顾性研究
Metabolic syndrome and the risk of perioperative ischemic stroke in non-cardiac surgery: a case-control retrospective study.
摘要(中文译文)
围手术期缺血性卒中（PIS）虽然罕见，但却是手术后一种灾难性的并发症。代谢综合征（MetS），又称胰岛素抵抗综合征，以肥胖、糖尿病、高血压和血脂异常为特征。据报道，MetS与手术并发症相关。然而，PIS与MetS之间的关联仍不明确。我们开展了一项病例对照研究，从中国人民解放军总医院2008年至2019年间223,415例非心脏手术患者中选取了139,191例受试者。采用单因素和多因素logistic回归分析来检验MetS与PIS的关联。应用倾向性评分匹配（PSM）和逆概率治疗加权（IPTW）来处理协变量的潜在混杂效应。进行亚组分析和敏感性分析以验证MetS与PIS关联的稳健性。在139,191例受试者中，328例（0.24%）发生了PIS。患有MetS的受试者发生PIS的风险增加2.18倍。在PSM和IPTW模型中，MetS的比值比分别为1.41和1.35。亚组分析显示该关联仍然显著。在敏感性分析中，排除使用特定药物的患者以及预后营养指数（PNI）低于38.8的患者后，结果仍然稳健。本研究证实MetS是中国非心脏手术患者PIS的独立预测因素，其中血压升高和血糖升高是这一关联的主要驱动因素。MetS中的异常参数，尤其是血糖水平升高和血压升高，与PIS发生几率的增加显著相关。患有MetS的手术患者需要更加重视PIS的预防。
Abstract
Perioperative ischemic stroke (PIS), although rare, is a devastating complication following surgery. Metabolic syndrome (MetS), also known as insulin resistance syndrome, is characterized by obesity, diabetes, hypertension and dyslipidemia. MetS has been reported to be associated with surgical complications. However, the association between PIS and MetS remains unclear. We conducted a case-control study by selecting 139,191 participants from 223,415 non-cardiac surgery patients at the Chinese PLA General Hospital between 2008 and 2019. Univariate and multivariate logistic regression analyses were performed to examine the association of MetS and PIS. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to address the potential confounding effects of covariates. Subgroup and sensitivity analyses were performed to verify the robustness of the association between MetS and PIS. Among 139,191 participants, 328 (0.24%) developed PIS. Participants with MetS had a 2.18-fold increased risk of PIS. In the PSM and IPTW models, the odds ratios for MetS were 1.41 and 1.35, respectively. Subgroup analyses showed that the association remained significant. In sensitivity analyses, the results remained robust after excluding patients on specific medications and those with a prognostic nutrition index (PNI) less than 38.8. This study confirms MetS as an independent predictor of PIS among non-cardiac surgical patients in China, with elevated blood pressure and glucose as the principal drivers of this association. Abnormal parameters in MetS, especially elevated glucose levels and elevated blood pressure, are significantly associated with increased odds of PIS. Surgical patients with MetS require increased attention to PIS prevention.
如何引用
AMA
Mengyao Qu, Yanan He, Lu Yu, Yingfu Li, Lei Yan, Huikai Yang, et al. Metabolic syndrome and the risk of perioperative ischemic stroke in non-cardiac surgery: a case-control retrospective study.. Frontiers in endocrinology. 2026; doi:10.3389/fendo.2026.1785277.
APA
Mengyao Qu, Yanan He, Lu Yu, Yingfu Li, Lei Yan, Huikai Yang, et al (2026). Metabolic syndrome and the risk of perioperative ischemic stroke in non-cardiac surgery: a case-control retrospective study.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1785277
GB/T 7714
Mengyao Qu, Yanan He, Lu Yu, Yingfu Li, Lei Yan, Huikai Yang, et al. Metabolic syndrome and the risk of perioperative ischemic stroke in non-cardiac surgery: a case-control retrospective study.[J]. Frontiers in endocrinology, 2026 doi:10.3389/fendo.2026.1785277.
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