急性颅脑损伤患者血糖、胰岛素、胰高血糖素水平变化及临床意义

Changes of blood glucose, insulin and glucagon in patients with acute craniocerebral injury and its clinical significance

目的 探讨急性颅脑损伤患者血糖、胰岛素、胰高血糖素水平的变化情况及临床意义。方法将2011年1月至2014年6月本院收治的急性颅脑损伤患者138例纳入研究组,根据格拉斯哥昏迷评分（GCS）将其分为重型颅脑损伤（GCS评分3-8分）65例,中型颅脑损伤（GCS评分9-12分）55例,轻型颅脑损伤（GCS评分13-15分）18例。另选同期本院120例健康体检者纳入对照组。比较并分析不同程度和不同预后颅脑损伤患者的血糖、胰岛素及胰高血糖素水平。结果 重型和中型颅脑损伤患者血糖、胰岛素及胰高血糖素水平均明显高于对照组（P〈0.05）,而轻型颅脑损伤患者血糖、胰岛素及胰高血糖素水平有所提高,但与对照组比较无显著差异（P〉0.05）。重度残疾和死亡及植物状态生存患者血糖、胰岛素及胰高血糖素水平均明显高于预后良好患者（P〈0.05）,而轻度残疾患者血糖、胰岛素及胰高血糖素水平有所提高,但与预后良好患者比较无显著差异（P〉0.05）。结论 有效控制急性颅脑损伤患者的血糖水平,可以减少患者继发性脑损伤,改善预后。

ObjectiveTo investigate the changes of blood glucose, insulin and glucagon in patients with acute craniocerebral injury and its clinical signiifcance.MethodFrom January 2011 to June 2014, 138 patients with acute craniocerebral injury were included in study group in our hospital. According to GCS, patients in study group were divided into severe craniocerebral injury （GCS score was 3-8 points） with 65 cases, moderate craniocerebral injury （GCS score was 9-12 points） with 55 cases, mild craniocerebral injury （GCS score was 13-15 points） with 18 cases. During the same period, 120 cases of health physical examination resrarch objects were selected as control group. The levels of blood glucose, insulin, glucagon of patients in different degrees and prognosis were compared and analyzed.ResultThe levels of blood glucose, insulin, glucagon of patients with severe craniocerebral injury and moderate craniocerebral injury were signiifcantly higher than control group （P〈0.05）. While the levels of blood glucose, insulin, glucagon of patients with mild craniocerebral injury were increased, but the differences were not significant statistically compared with control group （P〉0.05）. The levels of blood glucose, insulin, glucagon of patients with severe disability, death and vegetative state survival were increased signiifcantly compared with patients with well prognosis （P〈0.05）. While the levels of blood glucose, insulin, glucagon of patients with mild disability were increased, but the differences were not signiifcant statistically compared with patients with well prognosis （P〉0.05）.ConclusionEffectively control of blood glucose level in patients with acute craniocerebral injury can reduce the secondary brain injury, improve prognosis.