脑岀血急性期患者血糖水平与预后临床分析

Analysis of the level of blood glucose and prognosis in patients with intracerebral hemorrhage at acute stage

目的探讨脑出血患者急性期血糖水平与预后的关系。方法采用前瞻性队列研究方法连续登记2010-01—2012-02入住我科脑岀血患者,所有患者入院时行GCS评分及测定出血量,并连续检测入院时及7d内血糖水平,依据平均血糖水平分为4组,采用美国国立卫生院神经功能缺损评分量表(NIHSS)及改良Rankin量表评分(MRS)对患者入院时及1个月后进行评价,并对数据进行分析。结果不同组别之间出血量、GCS评分差异无统计学意义(P>0.05),但1个月后MRS和NIHSS评分改善比较差异有统计学意义(P<0.05),7.8～11.1mmol/L、>11.1mmol/L 2组预后差。结论脑出血患者发病后血糖水平不能反映病情严重程度,但可反映预后转归情况。

Objective To investigate the level of blood glucose,and the relationship between blood glucose and prognosis at acute stage in patients with intracerebral hemorrhage.Methods Consecutive patients after hemorrhage onset in the ward of neurology department were analyzed using prospective array method from January 2010 to February 2012.The blood glucoses at the first seven days after admission were detected.The patients were divided into four groups according to the average blood glucose levels.The bleeding volumes and GCS scores were recorded at admission.And the scores of Modification of Rankin Scale（MRS） and National Institute of Health Stroke Scale（NIHSS） at admission and at one month were also assessed.Results The blood glucose levels of patients at admission were not related with bleeding volumes and GCS scores,the 7.8~11.1 mmol/L and 11.1 mmol/L groups had a worse prognosis.Conclusion Blood glucose levels at admission can not reflect the severity of hemorrhage,but a high level of average blood glucose can indicate a worse prognosis.