急性期后缺血性卒中患者糖代谢异常的临床分析  

Analysis on the abnormality of glucose metabolism in post-acute non-diabetic ischemic stroke patients

作　　者：马凤琴[1] 魏欣[1] 李燕辰[1] 张淑敏[1] 

机构地区：[1]宁夏银川市第一人民医院,宁夏银川750001

出　　处：《宁夏医学杂志》2010年第12期1154-1155,共2页Ningxia Medical Journal

基　　金：宁夏银川市科技公关项目(2009050)

摘　　要：目的探讨急性期后缺血性卒中患者糖代谢状况及其相关因素。方法对132例急性期后缺血性卒中患者行糖耐量试验,根据血糖值将患者分为正常血糖组(NGT),糖调节受损组(IGR)和糖尿病组,分析各组的发病率,对各组的腰围、臀围、腰臀比、体重、体重指数(BM I)、空腹胰岛素及胰岛素抵抗指数(HOMA-IR)进行比较。结果 (1)急性期后缺血性卒中患者近2/3有糖代谢异常,若不行OGTT试验将使所有IGT和单纯2hPG高的糖尿病患者漏诊,总和达60.6%。(2)随着糖代谢异常的加重,腰围、臀围、腰臀比(WHR)、体重及BM I均呈增高趋势,NGT和IGR组间比较无统计学意义(P>0.05),和糖尿病组比较差异有统计学意义(P<0.05);HOMA-IR和LnInS值均随血糖水平增高而升高,各组间相比均有统计学意义(P<0.01)。结论急性期后缺血性卒中患者存在明显的糖代谢异常,随着糖代谢异常的加重,其他代谢指标也恶化,有必要对此类患者常规行糖耐量试验,做到早发现早干预,以预防脑血管病的发生。Objective To explore the glucose metabolism in post-acute non-diabetic ischemic stroke patients and to analyze the correlative factors.Methods After OGTT,132 patients in post-acute non-diabetic ischemic stroke were divided into NGT,IGR and DM.The morbidity of each group had been made.And waist circumference,hip circumference,WHR,weight,body mass index（BMI）,fasting insulin（FINS） and homeostasis model assessment（Homa-IR） were measured.Results The abnormality of glucose metabolism was about two thirds in Post-acute non-diabetic ischemic stroke patients.Without the use of OGTT,all impaired glucose tolerance and DM in PBG patients missed diagnosis.As the abnormality of glucose metabolism worsen,the waist circumference,hip circumference,WHR,weight and BMI were much higher（P0.05）.Both of HOMA-IR and LnInS levels（P0.01）.Conclusion The patients in post-acute non-diabetic ischemic stroke have abnormality of glucose metabolism.The worsen the glucose metabolism the aggravated the other metabolism.In order to prevent ischemic stroke,the patients in post-acute non-diabetic ischemic stroke should have OGTT to find glucose metabolism abnormality.

关 键 词：缺血性卒中 糖代谢异常 

分 类 号：R743.3[医药卫生—神经病学与精神病学]