重症脑梗死患者血糖控制水平对营养状态及病死率的影响  

Effects of the level of blood glucose control on nutritional status and mortality in severe cerebral infarction patients

作　　者：贺云鹏[1] 黄晓梅[2] 朱瑶丽[1] 王轶[1] 刘珊珊[1] 曾永寿 王小华[1] 

机构地区：[1]中山大学附属第五医院,广东珠海519000 [2]珠海市人民医院 [3]彝族自治州人民医院

出　　处：《中外医学研究》2011年第31期4-6,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的观察重症脑梗死患者的血糖控制水平对血浆白蛋白、前白蛋白、转铁蛋白及病死率的影响。方法 72例急诊入住ICU的重症脑梗死患者设为试验组,随机分为A、B两组各36例,另设25例健康自愿者为C组(正常对照组)。A、B组在营养支持过程中给予胰岛素,将血糖控制在不同水平,A组维持血糖在8～11.1mmol/L,B组维持血糖在4.4～8mmol/L。比较A、B两组之间入院第7d、14d、28d血浆白蛋白、前白蛋白、转铁蛋白及28d病死率的差异,并与C组比较营养指标之间的差异。结果同一时间,A、B两组之间血浆白蛋白、前白蛋白、转铁蛋白的差异均无统计学意义,与C组比较,各指标水平第7d、14d降低,第28天比较差异无统计学意义。与A组相比,B组患者入院第28天病死率降低。结论相对严格地控制重症脑梗死患者血糖水平有助于降低病死率,但未发现对血浆白蛋白、前白蛋白、转铁蛋白等营养指标水平有显著影响。Objective To investigate the effect of blood glucose control level on albumin, prealbumin, transferrin in plasma and mortality in severe cerebral infarction patients. Methods Seventy - two patients admitted to intensive care unit（ICU） were randomly divided into group A and group B, receiving intensive insulin therapy to maintain blood glucose level of 8 - 11.1 mmol/L and 4.4 - 8 mmol/L. Blood samples were obtained at 7 day and 14 day and 28 day after admittion to ICU. The level of albumin,prealbumin and transferrin in plasma were detected and were compared between each two group. Mortality were compared between the two group. Results Between group A and B, there were no significant difference in the level of albumin, prealbumin and transferrin in plasma, but the level of albumin, prealbumin and transferrin in plasma in group A and B were significantly decreased compared with group C. Compared with group A, mortality of group B was significantly decreased. Conclusion Relatively tight blood control in severe cerebral infarction patients may decrease mortality, but we didnt observed that significant effect on the level of albumin, prealbumin and transferrin in plasma.

关 键 词：脑梗死 营养 血糖 病死率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]