胰岛素干预脑梗死急性期伴应激性高血糖的临床研究

Clinical Study on Insulin for Acute Cerebral Infarction Patients with Stress Hyperglycaemia

目的:探讨胰岛素对脑梗死急性期应激性高血糖患者糖代谢的影响及其近期疗效。方法:选择84例伴有应激性高血糖的脑梗死急性期患者,随机分为治疗组(42例,胰岛素皮下注射)和对照组(42例,格列齐特口服),观察血糖达标时间、治疗后3个月的Barthel指数、治疗期间主要不良事件及药物不良反应。结果:治疗组血糖达标天数(2.8±1.3)天,明显短于对照组;治疗后3个月Barthel指数明显高于对照组,差异具有统计学意义(P<0.01)。治疗组主要不良事件发生例数少于对照组,但差异无统计学意义(P>0.05)。结论:与口服降糖药格列齐特比较,胰岛素能更好地改善脑梗死急性期应激性高血糖患者的糖代谢,尽早恢复患者生活能力。

Objective：To study the effect of insulin on abnormal glucose metabolism in acute cerebral infarction patients with stress hyperglycaemia and evaluate its short-term efficacy. Methods：Eighty-four acute cerebral infarction patients with stress hyperglycaemia were randomized into the treatment group（42 cases, insulin, H. i） and the control group （42 cases, glipizide P. o）. The meeting-target time of blood glucose and Barthel index after 3 months of treatment were examined, and main malign events and side-effects during the therapy were observed. Results：The meeting-target time of blood glucose in the treatment group（2.8 ± 1.3 ） days was significantly shorter than that in the control group. Barthel index three months after therapy was significantly higher compared with that in the control group（ P 〈 0. 01 ）. Main malign events during therapy in the treatment group were less than those in the control group, but with no significance（ P 〉 0.05 ）. Conclusion ：Insulin is superior to glipizide in improving the glucose metabolism and the living ability of acute cerebral infarction patients with stress hyperglycaemia.