胰岛素干预治疗对伴血糖升高之脑梗死患者临床预后的影响  

Effect of insulin interventional therapy on the prognosis of cerebral infarction with hyperglycemia

作　　者：陈维钧[1] 孙晓顺[1] 商敏[1] 朱红敏[1] 胡章良[1] 

机构地区：[1]荆州市第二人民医院神经内科,湖北省434000

出　　处：《实用诊断与治疗杂志》2004年第5期369-370,共2页Journal of Practical Diagnosis and Therapy

摘　　要：目的 :探讨胰岛素干预治疗对急性脑梗死高血糖状态的临床预后的影响。方法 :183例随机分为治疗组 (93例 )、对照组 (90例 )。除常规治疗外 ,治疗组加用普通胰岛素静脉滴注。在末梢空腹血糖值维持在 3.5～ 6 .1mmol/ L下 ,调整胰岛素用量 ,第 1周平均每日 2 0 u,第 2周 10～ 12 u,共 14 d,并分别于第 3d、第 7d、第 2 1d进行神经功能缺失评分 ,以判断治疗有效、无效。结果 :(1)治疗组第 3d恶化率 9.6 8% ,第 7d有效率 4 5 .16 % ,第 2 1d有效率 77.4 2 % ,对照组分别为 37.78% ,16 .6 7% ,4 6 .6 7%。各时段两组结果差异均有显著性 (其 P值为 <0 .0 1,<0 .0 5 ,<0 .0 1) ;(2 )胰岛素用量随病程减少。结论 :胰岛素对控制脑梗死病情进展 ,缩短病程 。Objective To investigate the effect of insulin interventional therapy on the prognosis of cerebral infarction with hyperglycemia. Methods One hundred eighty-three cases were divided randomly into treatment group (93 cases) and control group (90 cases). Besides the routine medical therapy, treatment group was given dripping of soluble insulin. The dose of insulin was adjusted to maintain the blood sugar value on an empty stomach below 3.5～6.1 mmol/L. The total course of treatment was 14 days, average 20 u per day in the first week, 10～12 u per day in the second week. The score to the loss of nerve function was calculated separately at the 3rd, 7th and 21st day, to evaluate whether the treatment was effective.Results ① In the treatment group, the worsen rate on the 3rd was 9.68%, the effective rate on the 7th day was 16.67%, and on the 21st was 77.42%. The values in control group were 38.33%, 16.67% and 46.67%. There was significant difference between the two groups in each period. ② There were reductions of the insulin dose as the progress went by. Conclusion It is suggested that the insulin should have a positive effect on controlling the progress of cerebral infarction and improving the prognosis.

关 键 词：胰岛素 脑血管病 脑梗死 血糖 

分 类 号：R743[医药卫生—神经病学与精神病学]