【摘要】 目的：分析上海市松江区缺血性脑卒中患者空腹血糖水平与死亡风险的关系，为改善患者预后提供科学依据。方法：2016年4月—2017年9月对1 368例缺血性脑卒中患者进行前瞻性队列研究，收集患者年龄、性别、疾病史、生化指标等资料，采用单因素和多因素COX回归分析不同空腹血糖水平与缺血性脑卒中患者死亡的关系。结果：1 368例缺血性脑卒中患者中位随访时间6.24年，总随访时长8 454.16人年，死亡例数114例，死亡密度为13.48/1 000人年，累计死亡率为8.33%。限制性立方样条分析结果显示，空腹血糖水平和缺血性脑卒中患者的死亡风险存在剂量反应关系。多因素COX回归分析结果显示，空腹血糖水平≥7.0 mmol/L与缺血性脑卒中患者的死亡风险增加有关，经性别、吸烟、饮酒、高血压、超重/肥胖、血脂异常分层后关联仍存在。结论：缺血性脑卒中患者空腹血糖水平≥7.0 mmol/L与患者死亡风险独立相关，建议关注并控制缺血性脑卒中患者空腹血糖水平，更好地改善患者预后。更多还原

【Abstract】 OBJECTIVETo evaluate the association between fasting blood glucose levels and risk of death in ischemic stroke patients in Songjiang, Shanghai, to provide a scientific basis for improving the prognosis of patients. METHODS A prospective cohort study was conducted on 1 368 patients with ischemic stroke in the community from April 2016 to September 2017, and the data of patients’ age, gender, disease history, biochemical indexes and other data were collected, and univariate and multivariate COX regression analysis was used to evaluate the relationship between different FBP levels and the death of IS patients. RESULTS During a median follow-up period of 6.24 years and a total follow-up period of 8 454.16 person-years for 1 368 ischemic stroke patients, there were a total of 114 deaths, with a density of deaths of 13.48/1 000 person-years, and a cumulative mortality rate of 8.33%. Restricted triple spline analyses were performed to show that that there was a dose-response relationship between FBP levels and the risk of death in ischemic stroke patients; multifactorial COX regression model analysis showed that FBP level≥7.0 mmol/L was associated with an increased risk of death in patients with ischemic stroke, and the association persisted after stratification by gender, smoking, alcohol consumption, hypertension, overweight obesity, and dyslipidemia. CONCLUSION FBP≥7.0 mmol/L in community ischemic stroke patients are independently associated with patient death, and it is recommended to pay attention to and control patients’ glucose levels to better improve their prognosis.更多还原