脑卒中急性期的糖代谢异常分析

The abnormal metabolism of the blood glucose in patients with acute stroke

目的:探讨脑卒中患者血糖代谢异常的发生率以及对卒中事件发生和影响预后的可能机制。方法:选择新入院脑卒中患者(A组)289例,抽取静脉血检查空腹血糖(FPG)和餐后2小时血糖(2hPG),必要时进行口服葡萄糖耐量实验(OGTT),并将存活者(B组)273例2周后复查。根据血糖结果分为糖代谢正常组和糖代谢异常组,并同时将A组行丙二醛(MDA)和超氧化物歧化酶(SOD)测定。结果:糖代谢异常发生率在A和B组的发生率分别为77.8%和55.6%。无论A组还是B组患者,糖代谢异常组的MDA升高和SOD降低与糖代谢正常组比较差异均有显著性。结论:糖代谢异常在脑卒中患者发生率较高,其脂质过氧化程度高。

Objective：To observe the prevalence of abnorvalence blood glucose metabolism and explore the potential mechanism of influence of glucose abnormality on prognosis in patients with cerebrovascular accident. Methods：T0 those new hospitalized patients with acute stroke （ group A） and collect venous blood to analysis fasting .plasma glucose （FPG） and 2 hours plasma glucose （2hPG） , Oral glucose tolerance test（OGTF） was performed when FPG or 2hPG was abnormal. Two weeks later the livers （group B） would be rechecked. According to OGTF, all patients were divided into three groups： diabetes mellitus group （DM） , impaired glucose tolerance group（IGT） and normal glucose tolerance group （NGT）. Malonaldehyde （MDA） and superoxide dismutase （SOD） were determined. Results： The incidences of abnormal glucose metabolism were 77.8% and 55.6% in group A and group B. MDA increase and SOD decrease were significantly different between group A and group B with abnormal blood glucose metabolism . There were significant differences in MDA （ P 〈 0. 001 ） and in SOD （ P 〈 0.001 ） between abnormal glucose metabolism group and NGT group in either group A or group B patients. Conclusions： Previously abnormal glucose metabolism is very common in patients with acute stroke. The patients with glucose abnormalities have more strengthened oxidative stress than those with NGT.