自发性脑出血急性期血糖及其他危险因素与预后的关系

Blood glucose and other risk factors in acute spontaneous cerebral hemorrhage and their effects on prognosis

目的探讨自发性脑出血患者急性期血糖及其他危险因素与预后的关系。方法回顾性分析我院575例自发性脑出血急性期非糖尿病患者的临床资料,将病例分为血糖升高组和血糖正常组,两组的近期病死率,并采用Logistic回归分析血糖及其他因素对自发性脑出血近期预后的影响。结果血糖升高组患者并发症发生率,肺部感染30.4%vs 18.9%,消化道溃疡27.4%vs 10.2%(均P<0.01),近期病死率均高于血糖正常组26.1 vs 9.6%(P<0.01),发病时意识障碍、高龄、血糖值和高血压影响疾病预后的因素。结论自发性脑出血急性期患者出现高血糖是提示近期预后不良的危险因素,发病时意识水平、高龄、血糖和高血压也是近期预后不良的重要危险因素。

Objective To analyse the clinical value of hyperglycemia and other risk factors in acute spontaneous cerebral hemorrhage（SCH） patients without diabetes, and their effects on prognosis. Methods Retrospective study was done in 575 non-diabetic patients with acute SCH. The patients were divided into increased blood glucose and normal blood glucose groups, and their complication and short-term mortality were compared. Logistic regression was used to analyse the effect of blood glucose and other risk factors on the prognosis of SCH. Results The complications in increased blood glucose group were significantly higher than those in normal blood glucose group, respectively lung infection 30.4% vs 18.9 ,digestive tract ulcer 27.4% vs 10.2（all P 〈0.01）. The former had higher mortality than the latter, 26.1% vs 9.6 % （ P 〈0.01）. Multivariate logistic regress analysis manifests conscious disturbance at the onset of illness, old age, hyperglycemia,and hypertension are factors that influence prognosis. Conclusion Hyperglycemia is a significant predictive risk factor for poor outcome. Severe disorder of consciousness, senility, blood glucose and hypertension are also very important risk factors.