短期胰岛素强化治疗急性脑血管病并发应激性高血糖的临床疗效

Effect of Short Term Intensive Insulin Therapy on Stress-induced Hyperglycemia in Patients with Acute Stroke

目的探讨短期胰岛素强化治疗对急性脑血管病并发应激性高血糖的临床疗效。方法将216例急性脑血管病并发应激性高血糖患者随机分为常规治疗组和胰岛素强化治疗组，每组108例。常规治疗组对应激性高血糖不作治疗，胰岛素强化治疗组采用短期胰岛素强化治疗，严格控制血糖在4．0～6．1mmol／L，治疗观测期为7d，期满后对比分析两组的临床疗效。结果胰岛素强化治疗组神经功能缺损程度较常规治疗组显著降低，胰岛素强化治疗组治疗后基本痊愈率和显著好转率明显高于常规治疗组，不良转归率显著低于常规治疗组（P〈0.05）。结论急性脑血管病并发应激性高血糖时采用短期胰岛素强化治疗能提高患者的治愈率，减轻伤残程度，提高患者的生活质量，降低死亡率，对改善急性脑血管病预后有重要临床意义。

Area To explore the effect of short term intensive insulin therapy on stress-induced hyperglycemia and outcornea in patients with acute stroke. Methods 216 patients with acute stroke and stress-induced hyperglycemia were randomly divided into normal therapy group （ n = 108） and short term intensive insulin therapy group （ n = 108）. The patients were maintained with normal glycemia （4.0 - 6.1 mmol/L）. After seven days, the results were observed. Results Neural function defect level of intensive insulin therapy group was lowered compared with normal therapy group. The cure rate and obviows recovery rate in intensive insuline therapy group was higher than normal therapy group, and its bad change rate was lower （ P 〈 0.05）. Conclusions Short term intensive insulin therapy can increase the curing rate and reduce mortality of patients with acute stroke and stress-induced hyperglycemia. The therapy has the important clinical meaning to improve prognosis.