急性缺血性脑卒中入院高血糖对出血性脑梗死的影响

Effect of admission hyperglycemia on hemorrhagic infarction in acute ischemic stroke

目的探讨入院时高血糖与自发性出血性脑梗死(HI)的相关关系。方法采用前瞻性队列研究,以连续入院的缺血性卒中患者为研究对象。检测入院空腹静脉血糖,全面收集与HI相关的临床特征,发病7天或症状恶化时复查头颅影像,了解HI的发生情况。进行单因素及多因素logistic回归分析,以探讨HI的独立预测因素。结果 112例研究对象进入统计分析,15例发现HI,38例存在入院高血糖,多元回归分析发现,既往糖尿病和入院高血糖与HI发生相关。结论入院时高血糖可能是发病一周内HI的预测因素,而既往糖尿病史也增加了梗死后出血的风险。

Objective To investigate the association of admission hyperglycemia with hemorrhagic infarction（HI） in acute ischemic stroke.Methods Consecutive patients admitted for ischemic stroke to central hospitals were included in this prospective cohort study.Admission blood glucose was measured,and all clinical characteristics related to HI as well as the data of CT/MRI performed during the first 7 days were collected.The potentially related factors of spontaneous HI were analyzed by using univariate analysis and multivariate logistical regression.Results Among 112 consecutive patients,15（13%） had HI.Admission hyperglycemia was found in 34%（n=38） of the patients.At logistic regression analysis,HI was predicted by high levels of admission blood glucose（OR： 8.319;95%CI： 1.303-53.137;P〈0.05） or history of diabetes（OR： 7.324;95%CI： 1.287-41.682,P〈0.05）,respectively.Conclusions Hyperglycemia during acute ischemic stroke predisposes to HI.