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目的探讨急性脑卒中患者的糖代谢异常情况及其对预后指标的影响。方法选取2010年1月～2011年12月某院收治的74例急性脑卒中患者为研究对象,分为出血性脑卒中组和缺血性脑卒中组,进行血糖、血清胰岛素和糖化血红蛋白检查,分析不同血糖水平对急性脑卒中预后指标的影响。结果①出血性脑卒中组出现糖代谢异常者12例(38.71%),低于缺血性脑卒中组41.86%(18/43),比较差异有统计学意义(P﹤0.05);缺血性脑卒中组平均血糖(10.4±1.4)mmol/L,高于出血性脑卒中组(9.8±1.7)mmol/L,而且均高于对照组,各组比较差异有统计学意义(P﹤0.05);出血性脑卒中组、缺血性脑卒中组以及健康对照组3组糖化血红蛋白和胰岛素值无明显差别,比较差异无统计学意义(P﹥0.05)。②本组资料显示,无论是出血性还是缺血性脑卒中,病情程度越重,血糖水平越高。③两组患者神经功能缺损评分(NDS)随血糖水平升高而升高,格拉斯哥昏迷评分(GCS)随血糖水平升高而降低,日常生活活动能力(ADL)随血糖水平升高而降低,比较差异有统计学意义(P﹤0.05)。出血性脑卒中组神经功能缺损评分(NDS)、格拉斯哥昏迷评分(GCS)以及日常生活活动能力(ADL)评分与缺血性脑卒中无明显差别,比较差异无统计学意义(P﹥0.05)。结论急性脑卒中患者血糖水平程度与预后密切相关,临床应及时动态监测糖代谢指标变化,并积极处理,以改善患者预后。
Objective To investigate the abnormal glucose metabolism in patients with acute stroke and its effect on prognosis. Methods A total of 74 acute stroke patients admitted to a hospital from January 2010 to December 2011 were selected as study objects. The patients were divided into hemorrhagic stroke group and ischemic stroke group. Blood glucose, serum insulin and HbA1c were detected. Analysis of the impact of different blood glucose levels on the prognosis of acute stroke. Results (1) 12 cases (38.71%) had abnormal glucose metabolism in hemorrhagic stroke group, which was lower than 41.86% (18/43) in ischemic stroke group (P <0.05); ischemic The average blood glucose in the stroke group was (10.4 ± 1.4) mmol / L, higher than that in the hemorrhagic stroke group (9.8 ± 1.7) mmol / L and higher than that in the control group (P <0.05) There was no significant difference between the three groups in hemorrhagic stroke group, ischemic stroke group and healthy control group, the difference was not statistically significant (P> 0.05). ② This group of data shows that, whether hemorrhagic or ischemic stroke, the more severe the disease, the higher the blood sugar level. (3) The neurological deficit score (NDS) in both groups increased with the increase of blood glucose level. The GCS decreased with the increase of blood glucose level. The activity of daily living (ADL) decreased with the increase of blood glucose level. The difference was statistically significant (P <0.05). NDS, GCS and ADL scores in hemorrhagic stroke group were not significantly different from those in ischemic stroke group (P> 0.05). Conclusion The level of blood glucose in patients with acute stroke is closely related to prognosis. Clinical indicators of glucose metabolism should be dynamically monitored in time and actively treated to improve prognosis.