脑出血急性期患者高血糖对脑水肿及预后的影响

Influence of hyperglycemia at acute stage in patients with intracerebral hemorrhage on brain edema and prognosis

目的探讨脑出血患者急性期血糖水平对脑水肿及预后的影响。方法脑出血患者95例,在急性期检测其空腹血糖水平,根据血糖水平分为高血糖组(38例)和正常血糖组(57例),通过头颅CT观察两组脑水肿的变化。在发病3个月后随访,采用改良Rankin量表(mRS)对两组患者进行神经功能评分,以评价其预后。结果高血糖组患者急性期血肿周围脑水肿体积[(17.55±2.48)ml]显著高于正常血糖组[(11.50±3.76)ml](P<0.05);发病3个月后高血糖组mRS评分(3.50±0.71)显著高于正常血糖组(2.80±0.63)(P<0.05)。结论脑出血患者急性期高血糖可加重脑水肿并影响其预后,应及时进行干预。

Objective To investigate the effects of glucose concentration at acute stage in patients with intracerebral hemorrhage（ICH）on brain edema and prognosis.Methods The glucose concentration of 95 ICH patients was examined at acute stage.According to the glucose concentration the patients were divided into two groups：hyperglycemia group（38 cases）and euglycemia group（57 cases）.The alteration of brain edema was observed by cranial CT.The neurological function was evaluated by the modified Rankin scales（mRS）3 months later,and the prognosis was analyzed.Results The brain edema volume around hematoma in acute stage of ICH was signilicantly bigger in hyperglycemia group[（17.55±2.48）ml] than in euglycemia group [（11.50±3.76）ml]（P〈0.05）.The mRS score of hyperglycemia group（3.50±0.71）was significantly higher than euglycemia group（2.80±0.63）3 months later（P〈0.05）.Conclusion The ICH patients in acute stage with hyperglycemia may have more seriously brain edema and poorer prognosis,which need timely intervention.