入院血糖水平与急性脑梗死患者短期预后的相关性分析  

Association between admission glucose level and short-term prognosis in patients with acute cerebral infarction

作　　者：李海燕[1] 沈光莉[1] 刘文宏[1] 付睿[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院神经内科,北京100038

出　　处：《中风与神经疾病杂志》2015年第11期982-984,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨入院血糖水平与急性脑梗死患者短期预后的相关性。方法回顾性连续性纳入2014年1月-2014年12月急性脑梗死患者560例,根据患者既往史、入院血糖水平及7 d OGTT结果,将其分为正常血糖组（206例）、应激性高血糖组（198例）及糖尿病组（156例）,比较3组基线资料、发病30 d的NIHSS评分及发病90 d的Barthel指数。结果 3组患者在年龄、入院时血糖水平、入院时Hb A1C以及入院时NIHSS比较时,存在显著性差异（P〈0.01）;糖尿病组入院时NIHSS评分明显高于正常血糖组（P〈0.01）。在30 d随访时,3组患者的NIHSS评分较发病时均有明显下降,有统计学意义（P〈0.01）;糖尿病组患者30 d时NIHSS评分明显高于正常血糖组及应激性高血糖组,具有统计学意义（P〈0.01）;在90 d随访时,应激性高血糖组及糖尿病组的Barthel指数明显低于正常血糖组,应激性高血糖组及糖尿病组的死亡率明显高于正常血糖组,均具有统计学意义（P〈0.01）;结论脑梗死患者急性期血糖水平升高与短期预后相关,影响神经功能恢复,增加死亡率,可作为评估病情的一项有效指标。Objective To observe the impact of admission glucose level on short-term prognosis in patients with acute cerebral infarction. Methods 560 patients with acute cerebral infarction were enrolled continuously and respectively from January 2014 to December 2014. According to their past medical history,admission glucose level and oral glucose tolerance test at day 7,they were divided into normal glucose group,stress hyperglycemia group and diabetes group. The baseline data,the National Institute of Health Stroke Scale（ NIHSS） at day 30 and the Barthel index at day 90 were analyzed among three groups. Results At admission,the age,blood glucose level,Hb A1 C and NIHSS had significant differences between three groups（ P〈0. 01）. The NIHSS of the diabetes group were higher compared to that of the normal glucose group and that of the stress hyperglycemia group,there were significant differences（ P〈0. 01）. At day 30,the NIHSS of three groups all declined compared to the admission level,the differences were significant（ P〈0. 01）. The NIHSS of the diabetes group were higher compared to that of the normal glucose group and that of the stress hyperglycemia group,there were significant differences（ P〈0. 01）. At day 90,the Barthel index of stress hyperglycemia group and diabetes group were lower than that of the normal glucose group,and the mortality of stress hyperglycemia group and diabetes group were higher than that of the normal glucose group,there were significantdifferences（ P〈0. 01）. Conclusion Elevated admission blood glucose related to the severity and short-term prognosis of acute ischemic stroke. It increased the risks of disability,death and might be an effective indicator for clinical evaluation.

关 键 词：脑梗死 应激性高血糖 糖尿病 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]