高血糖在动脉硬化性脑梗死患者急性期和恢复期中的作用

Role of hyperglycemia in acute and recovery phases of the patients with arteriosclerotic cerebral infarction

目的探讨高血糖在动脉硬化性脑梗死(ACI)患者急性期和恢复期中的作用和意义。方法用葡萄糖氧化酶法测定91例ACI患者急性期和恢复期的血糖浓度,按神经功能缺损程度标准于入院后1周内和3周后对患者进行神经功能缺损程度评分(NFV)。结果ACI患者急性和恢复期的血糖浓度显著高于健康对照组(P<0.01,P<0.05),急性期的血糖浓度又显著高于恢复期(P<0.05)。急性期和恢复期的脑梗死体积(CIV)为(8.75±1.21)和(6.34±4.14)cm3,NFV为(18.56±3.62)和(7.54±5.82),恢复期与急性期比较,两项参数均显著减小(P<0.05,P<0.01)。ACI患者急性期的血糖浓度与急性期和恢复期的CIV和NFV显著正相关(r=0.60,P<0.01;r=0.58,P<0.01;r=0.56,P<0.01;r=0.52,P<0.01),恢复期的血糖浓度与CIV和NFV不相关(r=0.09,P>0.05;r=0.08,P>0.05)。结论ACI患者急性期的高血糖加重缺血性脑损伤,提示临床预后不良;恢复期的高血糖在脑动脉粥样硬化中发挥重要的作用。

[Objective] To explore the role of hyperglycemia in acute and recovery phases of the patients with arteriosclerotic cerebral infarction（ACI）. [Methods] The serum concentrations of glucose after overnight fast were determined by biochemical methods in acute and recovery phases of 91 patients with ACI and so were done in 40 normal old ages as control, while the infarction volume and the neurological damage score in those with ACI were measured after 1 to 7 days and 21 days of admission. [Results] The serum concentrations of glucose after overnight fast in acute and recovery phases of the patients with ACI were significantly higher than those of the control subjects （P 〈0.01, P 〈0.05）, while the serum concentrations of glucose after overnight fast in acute of the patients with ACI were significantly higher than those in recovery phases of the patients with ACI. The infarction volume in acute and recovery phases of the patients with ACI were respectively （8.75±1.21） cm^3 and （6.34±4.14） cm^3, while the neurological damage score in acute and recovery phases of the patients with ACI were respectively （18.56±3.62） and （7.54±5.82）. The serum concentrations of glucose after overnight fast in acute of the patients with ACI were signifi- candy associated with the infarction volume and the neurological damage score in acute and recovery phases of the patients with ACI （r=0.60, P 〈0.01; r =0.58, P 〈0.01; r =0.56, P 〈0.01; r =0.52, P 〈0.01）, while the serum concentrations of glucose after overnight fast in recovery phases of the patients with ACI were not related to the infarction volume and the neurological damage score in those with ACI （r=0.09, P 〉0.05; r =0.08, P 〉0.05）. [Conclusions] The hyperglycemia in acute phases of the patients with ACI can aggravate ischemie brain damage and predict poor prognoses, while the hyperglycemia in recovery phases of the patients with ACI may play an important part in the pathological process of cerebral atherosclerosis