糖尿病与应激性高血糖对急性脑梗死患者预后影响研究

Effect of Diabetes Mellitus and Stress Hyperglycemia on the Prognosis of Patients with Acute Cerebral Infarction

目的探讨糖尿病与应激性高血糖对急性脑梗死(ACI)患者预后的影响。方法选择2013年2月—2016年2月广东省五华县人民医院住院治疗的ACI患者120例,依据患者病史及入院后血糖水平的变化分为糖尿病组、应激性高血糖组和正常血糖组,每组各40例。记录3组患者就诊时、治疗10 d后、治疗30 d后与治疗60 d后神经功能缺损评分(NIHSS)和Barthel指数,并统计3组患者的病死率。结果就诊时3组患者NIHSS评分、Barthel指数比较,差异无统计学意义(P>0.05);治疗10、30、60 d后3组患者NIHSS评分、Barthel指数比较,差异均有统计学意义(P<0.05);治疗10、30、60 d后,糖尿病组和应激性高血糖组NIHSS评分高于正常血糖组,Barthel指数低于正常血糖组,差异均有统计学意义(P<0.05)。治疗60 d后糖尿病组和应激性高血糖组患者病死率高于正常血糖组,差异有统计学意义(P<0.01)。结论对于伴有糖尿病或应激性高血糖ACI患者,应积极控制患者的血糖,对提高临床疗效与改善患者预后具有重要的临床意义。

Objective To observe and analyze the effect of diabetes mellitus and stress hyperglycemia on the prognosis of patients with acute cerebral infarction（ ACI）. Methods 120 patients with ACI from February 2013 to February 2016 in Wuhua County People’ s Hospital of Guangdong were selected, the patients were divided into diabetic mellitus group, stress hyperglycemia group and normal blood glucose group according to the patient’s history and the blood glucose level after admission,40 patients in each group. The NIHSS score and Barthel index were recorded for 3 groups of patients at the time of when treatment,after treatment of 10,30 and 60 d,the fatality rate of the 3 groups was also counted. Results When treatment,the NIHSS score and Barthel index among the 3 groups were not statistically significant（ P 〉 0. 05）; after treatment of 10,30 and 60 d,the NIHSS score and Barthel index among the 3 groups were statistically significant（ P 〈 0. 05）. After treatment of 10,30 and 60 d,the NIHSS score of the diabetic mellitus group and the stress hyperglycemia group was higher than that of the normal blood glucose group,and the Barthel index was lower than that of the normal blood glucose group,the difference was statistically significant（ P〈 0. 05）. After treatment of 60 d,the fatality rate of the diabetic mellitus group and the stress hyperglycemia group was higher than that of the normal blood glucose group, the difference was statistically significant（ P 〈 0. 01）. Conclusion It should actively control the patient’ s blood sugar for ACI patients with diabetes or stress hyperglycemia, it has important clinical significance to improve the clinical effect and patients’ prognosis.