二甲双胍联合胰岛素治疗急性脑梗死应激血糖增高的作用研究  

Study on Effect of Combined Use of Metformin and Insulin in Treatment of Stress Hyperglycemia Caused by Acute Cerebral Infarction

作　　者：张龙[1] 张均[1] 

机构地区：[1]南京大学医学院附属南京市鼓楼医院,南京210009

出　　处：《内科急危重症杂志》2011年第4期223-224,239,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:比较二甲双胍联合胰岛素与单用胰岛素或口服磺脲类降糖药控制急性脑梗死(ACI)应激性血糖增高对患者神经功能缺损改善的影响。方法:114例ACI合并应激性高血糖患者随机分为3组:联合治疗组(n=40,予胰岛素皮下注射+口服二甲双胍控制血糖),降糖药组(n=34,口服格列齐特控制血糖),胰岛素组(n=40,单用胰岛素皮下注射)。3组患者均按脑梗死常规治疗,分别于入院时、治疗后2周、4周根据全国第4届脑血管病学术会议通过的"脑卒中患者神经功能缺损程度评分标准"对患者进行神经功能缺损评分。结果:3组患者治疗后神经功能缺损评分均较入院时改善(P<0.05～0.01),而联合治疗组较其他2组改善更为明显(P<0.05)。结论:二甲双胍联合胰岛素控制应激性血糖增高更有利于ACI患者神经功能的恢复,提示二甲双胍可能有脑保护作用。Objective： To compare the effect of combined use of metformin and insulin, injection of insulin or glipizide orally alone on the improvement of neurologic deficit in treating patients with stress hyperglycemia caused by acute cerebral infarction （ACI）. Methods： One hundred and fourteen cases with ACI complicated with stress hyperglycemia were randomly divided into three groups： 41） cases of combined treatment group received injection of insulin subcutaneously and took metformin orally, 34 cases took glipizide orally and 40 cases received injection of insulin subcutaneously. All patients underwent routine treatment for cerebral infarction. Evaluations on patients＇ neurologic deficit were made based on Evaluating Standard on the Defect of Neural Function of Cerebrovascular Disease set by the 4th National Seminar on Cerebrovascular Disease at the time of hospitalization, 2 and 4 weeks after treatment respectively. Results： The neurologic deficit scoring of patients improved in all groups （P〈0. 05-0. 01）, whereas the improvement was significant in combined treatment group than that in the other two groups （P〈0. 05）. Conclusions： Combined use of metformin and insulin is more helpful for controlling stress hyperglyeaemia and thus the recovery of neurologic deficit in patients with ACI, and this indicates metformin has protective effect on brain.

关 键 词：二甲双胍 胰岛素 高血糖 急性脑梗死 并发症 药物疗法 

分 类 号：R587.1[医药卫生—内分泌]