急性缺血性脑卒中糖代谢异常66例分析

Impaired glucose tolerance in acute ischemic stroke: an analysis of 66 cases

目的探讨分析急性缺血性脑卒中与糖代谢异常之间的关系。方法回顾性分析2010年1月-2012年12月我院神经内科收治的66例急性缺血性脑卒中患者的临床资料,对本组患者均空腹行口服葡萄糖耐量试验,三个月后进行随访,分别观察急性期和三个月之后的糖代谢状况、糖代谢相关指标变化情况和NIHSS分型结果。结果本组66例急性缺血性脑卒中患者经口服葡萄糖耐量试验,急性期糖尿病、糖调节受损、血糖正常所占比例与三个月后相比差异不明显(P>0.05),无统计学意义;在糖化血红蛋白方面,糖尿病和糖调节受损组在急性期和三个月后均明显高于血糖正常组(P<0.05),有统计学意义;糖尿病三组患者在NIHSS分型上无显著差异(P>0.05),无统计学意义。结论急性缺血性脑卒中患者在脑血管病发生前就已经存在糖尿病或糖代谢异常,应激性因素只是加强了高血糖的表达,但并非急性缺血性脑卒中患者糖代谢异常的全部原因。

Objective To investigate the association of acute ischemic stroke（AIS） with impaired glucose tolerance（IGT）. Methods The clinical data of 66 AIS patients who were admitted to the Department of Neurology, The People＇s Hospital of Chuxiong, from January 2010 to December 2012 were analyzed retrospectively. Fasting oral glucose tolerance test（OGTT） was conducted, and the patients were followed up three months later. The glucose metabolism,changes in glucose metabolism-related indicators, and NIHSS scores in the acute stage and three months later were observed respectively. Results All the 66 AIS patients underwent OGTT, and the proportions of patients with diabetes,IGT, and normal blood glucose showed no significant differences in the acute stage and three months later（P〉0.05）; the diabetes group and IGT group showed significantly higher glycosylated hemoglobin levels than the normal blood glucose group in the acute stage and three months later（P〈0.05）. The three diabetes groups showed no significant differences in NIHSS scores（P〉0.05）. Conclusion AIS patients have already suffered from diabetes and IGT before getting cerebrovascular diseases; the stress factors can only increase the expression of hyperglycemia, and it is not the only reason for the IGT in AIS patients.