Effect of blood glucose variability on the outcome in patients with severe acute stroke

血糖变异性对重症急性卒中患者预后的影响

Objective To explore the correlation of blood glucose variability with the outcome in patients with severe acute stroke.Methods This retrospective clinical study was performed on patients with severe acute stroke.Based on the three months mRS score after discharge,they were divided into good outcome groups and poor outcome groups.The blood glucose on admission,mean blood glucose,blood glucose standard deviation,coefficient variation of blood glucose and other clinical data were compared between both groups.Multivariate logistic regression analysis was used to determine the independent predictors of poor outcome in patients with severe acute stroke.Results A total of 420 patients with severe acute stroke were included,207(49.3%)with good outcome groups,213(50.7%)with poor outcome groups.Multivariate logistic regression analysis showed that age,NIHSS score,GCS score,APACHEⅡscore,blood glucose standard deviation,coefficient of variation of blood glucose were independent predictors of poor outcome in patients with severe acute stroke on 3 months after discharge.Conclusion Blood glucose variability are the independent predictors of poor outcome of the three months after discharge in patients with severe acute stroke,the great range of glycemic excursion indicates poor outcome.

目的探讨血糖变异性对重症急性卒中患者预后的影响.方法对重症急性卒中患者进行回顾性分析,依据出院3 m的改良Rankin量表将患者分为预后不良组及预后良好组.对患者入院血糖、平均血糖、血糖标准差、血糖变异系数以及其他临床资料应用多变量Logistic回归分析,确定重症急性卒中患者预后不良的独立预测因素.结果共纳入420例重症急性卒中患者,其中预后良好组207例(49.3%),预后不良组213例(50.7%).多变量Logistic回归分析显示,年龄、NIHSS、GCS、APACHEⅡ、血糖标准差、血糖变异系数及其分类是影响其预后的独立危险因素.结论血糖变异性是重症急性卒中患者出院3 m预后不良的独立预测因素,血糖波动范围大提示预后不良.