脑卒中急性期糖代谢指标的临床观察

Clinic Observation on the Glycometabolism of the Patients with Acute Phase Stroke

目的 观察脑卒中急性期空腹血糖 (FPG) ,餐后两小时血糖 (PG2h) ,空腹血清胰岛素 (FINS) ,用以评估患者糖代谢紊乱 ,探讨急性期糖代谢指标变化的原因。方法 分别记录脑出血和脑梗死患者急性期FPG ,PC2h和FINS ,并和非急性期FPG ,PG2h及OGTT2小时血糖结果比较 ,计算胰岛素敏感指数 (ISI)。结果 (1)脑梗死患者中诊断为糖尿病的比例明显高于脑出血患者 (P <0 .0 1)。 (2 )脑出血患者急性期FPG高于非急性期FPG(P <0 .0 5 ) ,PG2h和OGTT2小时血糖结果符合率较高 (P >0 .0 5 )。脑梗死患者急性期FPG和非急性期FPG ,急性期PG2h与OG TT2小时血糖相近 (P >0 .0 5 )。 (3 )脑出血患者急性期和非急性期ISI差异有显著性意义 (P <0 .0 1)。结论 脑梗死患者糖尿病的发生率明显高于脑出血患者 ,印证了糖代谢紊乱是脑梗死的一个重要危险因素 ;脑出血患者评估糖代谢紊乱以PG2h为好 ,FPG仅作参考。脑梗死患者FPG和PG2h均可作为评估的指标 ;

Objectives:To observation of FPG PG2h FINS of the patients with stroke in acute phase,to observation of glycometabolism disorde and to approach the causes of the disorde.Methods:To record FPG PG2h FINS in cerebral hemorrhage group or infarction group in acute phase separately and compared these dates with in non-acute phase.To calculate ISI.Results:(1) the probability of the patients diagnosised to be DM is much higher in infarction than in hemorrhage (P<0.01),(2)FPG of the bemorrhage patients in acute phase of cerebral infarction is higher than in non-acute phase(P<0.05),PG2h are similar with OGTT 2 hour results(P>0.05).In the patients with cerebral infarction both FPG in acute and non-acute phase,PG2h in acute phase and OGTT 2 hours are similar(P>0.05).(3) there are significant difference in ISI in acute and in non-acute phase(P<0.01).Conclusions:The incidences of DM in the cerebral infarction is much more than in cerebral hemorrhagic one,that confirm glycometabolism disorde is a risk factor of cerebral and cardia disease,to evoluate glycometabolism in the patients with cerebral hemorrhage PG2h is a valuable mark,FPG is to be referenced only.Both FPG and PG2h are valuabe in the patients with cerebral infarction,in acute phase of cercbral hemorrhage neuroendocrine intervenes their glycometabolism.