不同强度降血糖对急性脑梗死后高血糖患者预后影响的研究  

The study of intensive insulin versus standard insulin for prognosis in patients with acute cerebral infarction and post stroke hyperglycemia

作　　者：杨赟[1] 王欣荣[2] 张昆南[1] 曹文锋[1] 吴晓牧[1] 

机构地区：[1]南昌大学,江西省人民医院神经内科,江西省神经病学研究所,江西南昌330006 [2]江西省妇幼保健院产前诊断科,江西南昌330006

出　　处：《中风与神经疾病杂志》2016年第10期901-904,共4页Journal of Apoplexy and Nervous Diseases

基　　金：江西省卫生计生委科技计划(No.20155072)

摘　　要：目的 通过观察伴有卒中后高血糖的急性脑梗死患者,初步探讨强化降血糖与标准降血糖对其预后的影响。方法 纳入106例发病72 h内的颈内动脉系统脑梗死患者,随机分为将末梢血糖控制在6-8 mmol/L的强化降血糖组及将末梢血糖控制在8-10 mmol/L的标准降血糖组,各53例,均予以胰岛素控制血糖达72 h。随访3 m,主要终点事件为：7 d NIHSS评分,3 m mRS评分;次要终点事件为：3 m死亡率,3 m严重残疾率,低血糖发生率。结果 两组间7 d NIHSS评分与3 m mRS评分均具有显著统计学差异（P〈0.05）。但两组间3 m死亡率,3 m严重残疾率,低血糖发生率均无显著统计学差异（P〉0.05）。结论 对急性脑梗死后高血糖患者强化降血糖较标准降血糖能显著改善神经功能缺损评分,对轻中度患者获益更明显,但减少死亡及改善严重残疾不明显。Objective To explore the effect of intensive insulin versus standard insulin on the prognosis in patients with acute cerebral infarction and post stroke hyperglycemia .Methods 106 cases of anterior circulation ischemic stroke within 72 hours were recruited .They were randomized to receive intensive insulin or standard insulin for 72 hours.The cap-illary glucose was confined to 6-8 mmol/L in intensive insulin group,while the capillary glucose was confined to 8-10 mmol/L in standard insulin group .We followed up all the patients for 3 months.Primary endpoint：the NIHSS scores at Day 7,the mRS scores at Day 90.Secondary endpoint：the mortality within 3 months,the rate of disability within 3 months,hypo-glycemias .Results The NIHSS scores at Day 7 and the mRS scores at Day 90 were statistically different between groups （ P〈0.05）,while the mortality within 3 months,the rate of disability within 3 months,and hypoglycemias were not statistically different between groups（P＆gt;0.05）.Conclusion Compared to standard insulin group,intensive insulin group weren＇t better at decreasing the mortality and the rate of disability in patients with acute cerebral infarction and post stroke hyperglyce -mia,while better at improving neurologically functional sores ,especially for mild to moderate cerebral infarction .

关 键 词：急性脑梗死 高血糖 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]