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目的探讨2型糖尿病(T2DM)及单纯性糖耐量受损(I-IGT)对急性脑梗死患者病情及预后的影响。方法根据血糖情况,将195例急性脑梗死患者分为血糖正常组(54例)、T2DM组(63例)和I-IGT组(78例)。采用美国国立卫生院卒中评分量表(NIHSS)评估患者入院时及入院1周时的病情。采用改良Rankin评分量表(mRS)于发病后1个月、3个月评估患者的预后。结果三组患者入院时NIHSS评分相仿(P>0.05);入院1周时,T2DM组和I-IGT组NIHSS评分均显著高于正常组(P<0.05)。T2DM组发病后1个月、3个月的预后不良率分别为57.1%、44.4%,I-IGT组分别为48.7%、41.0%,均明显高于与正常组的31.5%、20.4%(P<0.05)。T2DM组与I-IGT组并发症发生率分别为77.8%和70.5%,亦明显高于与正常组的27.8%(P<0.05)。结论 T2DM及I-IGT使急性脑梗死患者病情加重,预后不良。
Objective To investigate the effects of type 2 diabetes mellitus (T2DM) and simple impaired glucose tolerance (I-IGT) on the severity and prognosis of patients with acute cerebral infarction. Methods According to the blood glucose, 195 patients with acute cerebral infarction were divided into normal glucose group (54 cases), T2DM group (63 cases) and I-IGT group (78 cases). The National Institutes of Health Stroke Scale (NIHSS) was used to assess the patient’s condition at admission and at 1 week of admission. Patients were assessed for prognosis at 1 month and 3 months after onset using the modified Rankin Rating Scale (mRS). Results The NIHSS scores of the three groups were similar at admission (P> 0.05). At 1 week after admission, the NIHSS scores of T2DM group and I-IGT group were significantly higher than those of normal group (P <0.05). The poor prognosis at 1 month and 3 months after onset of T2DM was 57.1% and 44.4%, respectively, and 48.7% and 41.0% in I-IGT group were significantly higher than those in normal group (31.5% and 20.4%, P <0.05). The complication rates of T2DM group and I-IGT group were 77.8% and 70.5% respectively, which were also significantly higher than those of the normal group (27.8%, P <0.05). Conclusion T2DM and I-IGT aggravate the patients with acute cerebral infarction and have a poor prognosis.