BACKGROUND As hyperglycemia and leukocytosis individually predict poor outcome in acute ischemic stroke (AIS), we aimed to determine the significance of their combination on functional outcome and symptomatic intracerebral hemorrhage (sICH) among participants of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). METHODS Post-hoc analyzes of the full ENCHANTED cohort, an international, multicenter, quasi-factorial, randomized, open, blinded outcome-assessed trial of low- versus standard-dose intravenous alteplase and early intensive versus standard blood pressure (BaP) lowering treatment in 4557 thrombolysis-eligible and treated AIS patients. Patients were divided into four groups according to baseline blood glucose and white blood cells (WBC) levels: A (normal glucose + WBC), B (hyperglycemia + normal WBC), C (normal glucose + high WBC), and D (hyperglycemia + high WBC). Logistic regression models were used to determine associations of each group and poor functional outcome (modified Rankin scale scores 2-6) at 90 days and sICH within 48 h, adjusted for confounders. Quality of model fit was examined with Akaike information classification (AIC), Bayesian information classification (BIC), and likelihood ratio test. RESULTS Of 4181 AIS patients included in analyzes, and with group A as the reference, an increasing odds of poor functional outcome was evident across groups B (odds ratio [OR] 1.38, 95 % confidence interval [CI] 1.17-1.63), C (OR 1.26, 95 %CI 0.99-1.60), and D (OR 2.26, 95 %CI 1.79-2.85) (P trend <0.001). Group D patients also had a higher rate of sICH (P trend <0.05). The model fit with the combination of blood glucose and WBC was better than models of their individual components. CONCLUSIONS Using a combination of blood glucose and WBC provides strong prognostic significance than either alone in thrombolyzed AIS patients.

中文翻译：

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血糖和白细胞在预测急性缺血性中风后的结果中的联合效用：ENCHANTED 试验

背景 由于高血糖和白细胞增多单独预测急性缺血性卒中 (AIS) 的不良预后，我们旨在确定它们的组合对高血压和血栓溶解卒中强化控制研究 (ENCHANTED) 参与者的功能预后和症状性脑出血 (sICH) 的意义）。方法 完整 ENCHANTED 队列的事后分析，这是一项国际、多中心、准因子、随机、开放、盲法结果评估试验，对低剂量与标准剂量静脉阿替普酶和早期强化与标准血压 (BaP) 降低治疗进行对比在 4557 名符合溶栓条件和接受治疗的 AIS 患者中。根据基线血糖和白细胞（WBC）水平将患者分为四组：A（正常葡萄糖+WBC），B（高血糖+正常WBC），C（正常葡萄糖 + 高 WBC）和 D（高血糖 + 高 WBC）。Logistic 回归模型用于确定每组与 90 天和 48 小时内 sICH 不良功能结果（改良 Rankin 量表评分 2-6）的关联，并针对混杂因素进行调整。模型拟合的质量通过 Akaike 信息分类 (AIC)、贝叶斯信息分类 (BIC) 和似然比检验进行检查。结果 在分析中纳入的 4181 名 AIS 患者中，以 A 组为参考，B 组功能结果不良的几率明显增加（比值比 [OR] 1.38，95 % 置信区间 [CI] 1.17-1.63），C (OR 1.26, 95%CI 0.99-1.60) 和 D (OR 2.26, 95%CI 1.79-2.85)（P 趋势 <0.001）。D 组患者的 sICH 发生率也较高（P 趋势 <0.05）。与血糖和 WBC 组合拟合的模型优于其单个成分的模型。结论 在溶栓的 AIS 患者中，与单独使用血糖和 WBC 相比，联合使用血糖和 WBC 具有更强的预后意义。