脑卒中后糖尿病和糖调节异常的临床研究  

Clinical study on diabetes mellitus and impaired glucose regulation in patients with stroke

作　　者：胡志兵[1] 丁冬梅[2] 曹莹[1] 戴建武[1] 李翠琼[1] 朱慧芬[1] 

机构地区：[1]广州市第十二人民医院神经内科,510620 [2]南方医科大学珠江医院医务处,广州510282

出　　处：《中华神经医学杂志》2007年第5期505-507,516,共4页Chinese Journal of Neuromedicine

摘　　要：目的调查脑卒中患者中糖尿病和糖调节异常的发病情况,探讨口服葡萄糖耐量试验(OGTT)的临床意义。方法对2004年1月～2006年6月收治入院的547例脑卒巾患者进行空腹血精、糖化血红蛋白(GHbAlc)等检测,臀记患者的临床资料,对既往未诊断糖尿病而空腹血糖在5.6～6.9 mmol/L的患者存适当时候进行OGTT,糖代谢分类采用2003年美同糖尿病学会建议标准。结果547例脑卒中患者住院前糖尿病的诊断率为13.9%,住院后检查发现糖尿病的患病率34.4%,精调节异常26.5%;脑梗死、脑出血、蛛网膜下腔出血糖尿病的伴发率分别为45.1%、20.5%、13.2%,糖调节异常的伴发率分别30.2%、23.2%、16.2%;227例空腹血糖在5.6～6.9mmol/L的患者中,OGTT检查后发现,19.8%患者可诊断为糖尿病,42.3%提示糖耐量异常。结论脑卒中患者合并高比例的糖尿病和糖调节异常;缺血性卒中发病率高于出血性卒中;空腹血糖在5.6～6.9 mmol/L的患者中,OGTT可以发现大量的糖尿病和糖耐量异常患者。Objectives To investigate the prevalence of diabetes and impaired glucose regulation （IGR） among the patients with stroke and to study the clinical significance of oral glucose tolerance test in the patients. Methods A survey was conducted among the inpatients who were attacked by stroke registered in our department of neurology from Jan 2004 to Jun 2006. The fasting plasma glucose （FPG） level and glycosylated hemoglobin （GHbAIc） were tested when the all patients were hospitalized. Those who had not been diagnosed as diabetes previously but their FPG level within 5.6-6.9 mmol/L were checked through oral glucose tolerance test （OGTT）. The criteria （2003） recommended by American Diabetes Association were used for glycometabolic categorization. Results 13.9% of the 547 inpatients with stroke had been previously diagnosed as with diabetes before they were attacked by stroke. According to the FPG level and the OGTT results, we found that the prevalence rates of diabetes and IGR were 34.4% and 26.5%, respectively among the inpatients. The prevalence rates of diabetes in cerebral infarct, intracerebral hemorrhage, subarachnoid hemorrhage were 45.1%, 20.5%, 13.2%, respectively, and the rates of IGR were 30.2%, 23.2%, 16.2%, respectively. OGTT was carried out in 227 inpatients whose FPG levels were between 5.6-6.9 mmol/L, 19.8% of which were classified as with diabetes, and 42.3% with impaired glucose tolerance （IGT）. Conclusion The prevalence rates of diabetes and IGR are very high among the stroke patients. It is higher in the ischemic stroke than that in the hemorrhagic stroke. For the patients with FPG within 5.6-6.9 mmol/L, OGTT can help us find more and more new patients with diabetes or IGT.

关 键 词：脑卒中 糖尿病 糖调节异常 糖耐量异常 口服葡萄糖耐量试验 

分 类 号：R587.1[医药卫生—内分泌] R743.3[医药卫生—内科学]