高血糖—弥漫性轴索损伤患者神经损伤严重度和预后的指示剂(英文)  

Hyperglycemia as an indicator of neurological severity and outcome in patients with diffuse axonal injury

作　　者：赵灵[1] 李永波[1] 侯玉宇[1] Boyce C 楚磊[1] 曾凡[1] 

机构地区：[1]暨南大学医学院第三附属医院外科ICU,广州519000 [2]澳大利亚墨尔本穆沙医疗中心

出　　处：《中华神经医学杂志》2006年第2期174-179,共6页Chinese Journal of Neuromedicine

摘　　要：目的研究外伤性弥漫性轴索损伤患者高血糖与预后的关系。方法前瞻性对 118例中、重型外伤性弥漫性轴索损伤患者进行研究, 监测入院时、入院后 3 d、7 d 和两周时的神经元特异性烯醇化酶(NSE)、血糖、GCS, 于出院时和三个月后作 GOS 预后评分, 分析血糖水平与损伤严重度和神经功能预后的关系。结果死亡患者入院时血糖水平显著高于存活患者 (260mg/dLvs 130 mg/dL,P<0.005)。入院时血糖≥260 mg/dL 的患者均死亡。结论弥漫性轴索损伤常发生应激反应性早期高血糖, 它是损伤严重度的指示剂和可靠的预后预测指标。Objective This study aimed to better examine the relationship between hyperglycemia and outcome after traumatic diffuse axonal injury （TDAI）. Methods We prospectively studied 118 patients with moderate or severe TDAI [Glasgow Coma Scale scores （GCS）, 3-12] who were treated conservatively in the surgical intensive care unit of zhuhai hospital between January 2000 and December 2004. Serum glucose, GCS and Glasgow Outcome Scale （GOS） of all the patients were measured： serum glucose, GCS score was recorded on admission, on days 3, 7 and 2 weeks ; Outcome was determined by GOS score at discharge and atter 3 months , respectively and the data were analyzed statistically to determine the relationship between serum glucose levels, severity of injury, and neurological outcome. Results Patients who died had significantly higher admission serum glucose values than those patients who survived （230 mg/dL vs 130 mg/dL, P〈0.005）. Admission serum glucose t〉210 mg/dL was uniformly associated with a worse outcome. Conclusion Early hyperglycemia is a significant indicator of its severity, and a reliable predictor of outcome to TDAI.

关 键 词：高血糖 弥漫性轴索损伤 预后 

分 类 号：R651.15[医药卫生—外科学]