入院血糖及血糖变异性与原发性脑桥出血患者预后的相关性研究  

Association of Admission Blood Glucose and Glycemic Variability on Prognosis of Primary Pontine Hemorrhage

作　　者：苏静[1] 林斌[2] 徐丽娟[2] 温江[2] 龚浩[2] Su Jing;Lin Bin;Xu Lijuan(Department of Endocrinology,The People’s Hospital of Mianzhu,Mianzhu,Sichuan,618200,China)

机构地区：[1]绵竹市人民医院内分泌科,四川绵竹618200 [2]绵竹市人民医院神经外科,四川绵竹618200

出　　处：《黑龙江医学》2024年第12期1427-1429,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨入院血糖及血糖变异性与原发性脑桥出血患者预后的相关性。方法:收集2013年2月—2021年2月绵竹市人民医院神经外科住院的100例脑桥出血患者入院时格拉斯哥昏迷评分(GCS)、入院24 h内血糖和血肿量等临床资料。分析各因素与入院30 d存活情况及90 d神经功能恢复情况的相关性和入院血糖与血肿量及入院时GCS的关系。结果:30 d死亡组与存活组比较,入院GCS评分较低,而入院血糖及血肿量较高,差异有统计学意义(χ^(2)=6.742、3.171、6.168,P<0.05);脑桥出血后90 d神经功能恢复不良组与良好组比较,其在入院GCS及血肿量上,差异有统计学意义(χ^(2)=6.437、6.495,P<0.05),但在入院血糖上,差异无统计学意义(χ^(2)=1.574,P>0.05)。logistic分析结果显示,入院时GCS是影响30 d存活情况的独立危险因素,GCS及血肿量是90 d神经功能恢复情况的影响因子,差异有统计学意义(P<0.05)。采用Spearman相关性分析显示,患者入院血糖与脑桥出血血肿量呈直线正相关(r=0.232,P<0.05),入院血糖与入院GCS呈直线负相关(r=-0.257,P<0.05),血肿量与GCS呈直线负相关(r=-0.816,P<0.05)。结论:入院血糖及血糖变异性不是脑桥出血早期死亡及90 d功能预后不良的独立危险因素,但入院血糖与脑桥出血患者的血肿量及GCS呈线性相关,入院血糖水平高的脑桥出血患者往往表现为早期危重状态,早期死亡率更高。Objective:To investigate the association of admission blood glucose and glycemic variability on prognosis of primary pontine hemorrhage.Methods:Clinical data,such as Glasgow coma score(GCS),blood glucose and hematoma volume within 24 h after admission of 100 patients with pontine hemorrhage admitted to the Department of Neurosurgery,Mianzhu People’s Hospital from February 2013 to February 2021 were collected.The correlation of related factors with 30-day survival and 90-day neurological recovery of primary pontine hemorrhage was analyzed,and the relationship between admission blood glucose,hematoma volume and GCS on admission was analyzed.Results:Compared with the survival group,the admission GCS score of the 30-day death group was lower,while the admission blood glucose and hematoma volume were higher(χ^(2)=6.742,3.171,6.168;P<0.05).There was significant difference in admission GCS score and hematoma volume between poor neurological function recovery group and good group(χ^(2)=6.437,6.495;P<0.05),but no statistically significant difference in admission blood glucose(χ^(2)=1.574,P>0.05).Logistic regression analysis showed that only admission GCS score was an independent risk factor for 30-day death while GCS score and hematoma volume were influencing factors for 90-day neurological recovery(P<0.05).Spearman correlation analysis showed that there was positive correlation between admission blood glucose and hematoma volume of pontine hemorrhage(r=0.232,P<0.05),a negative correlation between admission blood glucose and GCS on admission(r=0.257,P<0.05),and between hematoma volume and GCS(r=-0.816,P<0.05).Conclusion:Admission blood glucose and glycemic variability are not independent risk factors for early death and poor 90-day functional prognosis in patients with pontine hemorrhage.However,there is linear correlation between admission blood glucose,hematoma volume and GCS.Patients with high admission blood glucose levels tend to be in an early critical state and higher early mortality.

关 键 词：原发性脑桥出血 入院血糖 血糖变异性 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]