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目的观察比较短效加中效胰岛素、预混胰岛素、预混胰岛素类似物及长效胰岛素对急性脑梗死合并高血糖患者的血糖控制效果及神经功能缺损的改善情况。方法急性脑梗死合并高血糖患者116例,除脑梗死常规治疗外采用胰岛素皮下注射治疗。患者随机分为4组,分别给予诺和灵R+诺和灵N、诺和灵30R、诺和锐30和长秀霖。试验过程为期3个月,观察4组患者血糖控制情况,并于治疗前后进行神经功能缺损评分(NIHSS评分),比较各种胰岛素制剂的应用效果。结果 4种胰岛素制剂治疗均能降低血糖和糖化血红蛋白(HbA1C)水平,且诺和锐30组显著低于其他3组(P<0.05)。4组患者治疗后NIHSS评分较治疗前显著降低(P<0.05),其中诺和锐30组优于其他3组(P<0.05)。结论急性脑梗死合并高血糖患者接受胰岛素治疗能够有效控制血糖、降低病残率并改善长期生存质量;预混胰岛素类似物诺和锐30综合疗效优于其他胰岛素,更适用于急性脑梗死合并高血糖患者。
Objective To compare the effects of short-acting plus moderate-acting insulin, premixed insulin, premixed insulin analogues and long-acting insulin on blood glucose control and neurological deficits in patients with acute cerebral infarction complicated with hyperglycemia. Methods A total of 116 patients with acute cerebral infarction complicated with hyperglycemia were treated with insulin subcutaneous injection except for routine treatment of cerebral infarction. Patients were randomly divided into 4 groups, respectively, Novolin and norepinephrine N, Novolin and 30R, Novartis sharp 30 and Changxiu Lin. The duration of the experiment was 3 months. The blood glucose control was observed in 4 groups. Neurological deficit scores (NIHSS scores) were obtained before and after treatment. The effects of various insulin preparations were compared. Results All four insulin preparations decreased blood glucose and HbA1C levels, and Novo-Rui 30 group was significantly lower than the other three groups (P <0.05). The scores of NIHSS in the four groups were significantly lower than those before treatment (P <0.05), and Novo-Rui 30 was better than the other three groups (P <0.05). Conclusions Insulin treatment in patients with acute cerebral infarction and hyperglycemia can effectively control blood sugar, reduce the morbidity and improve long-term quality of life. The premixed insulin analogue Novo-Rui 30 has better curative effect than other insulin and is more suitable for acute cerebral infarction complicated with high Blood sugar patients.