5316例急性脑血管病早期高血糖调治技术研究(英文)

Study on modulating hyperglycemia following ACVD early stage in 5316 patients

目的探讨急性脑血管病早期高血糖调治范围及调治方法。方法急性脑血管病5316例病人被随机分入治疗组、对照1和2组。治疗组依据急性脑血管病后高血糖水平,早期静脉泵入胰岛素,加用益气调糖合剂。采用8+点法和5+点法监测血糖。对照组采用常规治疗方法。观察临床疗效和预后状况。结果治疗第10、30d,CSS评分,治疗组在治愈、显效、好转及总有效方面均明显高于对照1、2组(P<0.01),而在无效或恶化以及死亡方面明显低于对照1、2组(P<0.01)。对照1、2组预后均较治疗组差(P<0.01)。结论急性脑血管病后高血糖的目标血糖,在应激性者应为7.00～7.50mmol/L,糖尿病性为MBGC+1.50～2.00mmol/L。8+点法和5+点法可以很好地监测血糖水平。此调治技术能够使高血糖恒定在理想的目标血糖水平。

[Objective] To explore the ranges and the methods of modulating hyperglycemia following ACVD early stage. [Methods] The 5316 patients with ACVD were randomly divided into treatment group, control group1 and 2. According to the level that the blood glucose concentration(BGC) increased after ACVD in treatment group, insulin was early used to modulate hyperglycemia and YiQi mixed preparation modulating glucose added. BGC was monitored with the 8+ periods and 5+ periods. Conventional therapy was used in control group 1 or 2.The changes were observed in respects of clinical effect and prognosis. [Results] On admission 10- or 30-days, it was more obviously raised that the healing rate, clear effect, improvement and total healing efficiency were evaluated with CSS in treatment group compared with control group 1 and 2 (P <0.01). It was more obviously lowered that the incidence of nullity or exacerbation and mortality were abserved in treatment group, compared with control group 1 and 2 (P <0.01). The prognosis was aggravated in control groups. [Conclusions] The clinical better healing effect is obtained when the stress hyperglycemia is modulated to 7.00~7.50 mmol/L and the diabetic to MBGC+1.50-2.00 mmol/L. BGC was better monitored with the 8+ periods and 5+ periods. The satisfying BGC target is maintained by means of this technology of modulating hyperglycemia.