急性脑梗死患者前期应激性高血糖与脑梗死分型及预后的关系

RELATIONSHIP BETWEEN ACUTE STRESS HYPERGLYCEMIA IN PATIENTS WITH PRE-INFARCTION AND CEREBRAL INFARCTION CLASSIFICATION AND PROGNOSIS

目的探讨脑梗死患者早期高血糖的发生与四种脑梗死分型、病情转归等预后问题之间的关系。方法回顾分析2013年6月—2015年1月到该院就医并确诊的140例急性脑梗死患者,按所有患者空腹血糖测量结果分成二组,每组70例,其中A组脑梗死患者的血糖含量均高于正常水平,而B组脑梗死患者的血糖含量正常。通过各分型血糖含量分布、早期神经功能恶化情况、入院后前5d的NIHSS评分情况以及脑梗死患者病情转归等情况,分析判断脑梗死患者前期高血糖与其分型及预后情况之间的关系。结果 TACI分型的高血糖发生率(54.05%)远高于其他三种分型(PACI、LACI和POCI),其中PACI分型的高血糖发生率(16.67%)最低;A组脑梗死患者的神经功能恶化倾向率(34.29%)远高于B组(12.86%);A组脑梗死患者在入院后前5d的评分状况均普遍都高于B组;A组治疗无效率(14.29%)和患者病死率(14.29%)均高于B组脑梗死患者的,而治疗总体有效率(71.43%)比B组脑梗死患者(88.57%)要低且二组间的各项数据差异较大(P<0.05)。结论急性脑梗死患者发病时血糖值的升高对脑梗死分型有影响,且能增加脑梗死患者神经功能恶化程度,与其预后紧密相连。

Objective To explore the relationship between acute stress hyperglycemia in patients with pre- infarction and cerebral infarction classification and prognosis. Methods The 140 cases of acute cerebral in- farction patients were divided into two groups, higher levels of fasting blood glucose measurements was in group A, group B with normal blood sugar. Blood sugar level, early neurological worsening, NIHSS scores within 5d after admission and the patients＇ outcome were observed, and then according to brain stem type and prognosis development judged the relationship with the stress hyperglycemia. Results The incidence of high blood sugar in the TACI typing （54.05%） was higher than the other three sub- type （PACI, LACI and POCI）, which incidence of high blood sugar （16.67%） in PACI typing was minimum. Group A of pa- tients with neurological brain stem deterioration trend rate （34. 29 %） was higher than group B （12.86 %） ; NIHSS score in group A of cerebral infarcti6n patients in the first five days after admission was generally higher than group B, whose therapy inefficiency （14. 29%） and mortality （14. 29%） were higher than group B, but the treatment overall response rate （71.42%） was lower than group B （88.57%） （P〈0. 05）. Conclusion Early acute cerebral infarction is closely with cerebral stress hyperglycemia type and prog- nosis development.