脑干梗死与急性应激性血糖升高率的相关性

Correlation between brainstem infarction and stress induced glucose up-regulation ratio

目的探讨脑干梗死是否更易于发生急性应激性的血糖升高。方法收集2008年2月至2012年5月在南京大学医学院附属鼓楼医院神经内科住院的336例急性脑梗死患者,用应激性血糖升高率(SIGUT)反映应激性的血糖升高,比较非脑干梗死组和脑干梗死组之间SIGUT水平的差异;SIGUT四分位数分组后,比较相关因素在四分位分组间的差异;回归分析高水平SIGUT的发生是否与脑干梗死相关。结果SIGUT的水平在非脑干梗死组和脑干梗死组之间存在显著差异,后者呈现明显的升高趋势(1.060±0.272比1.159±0.301)(P=0.020);在四分位分组间,男性、糖尿病、脑干梗死所占百分比和空腹血糖(FBG)、糖化血红蛋白(HbA1c)、美国国立卫生研究院卒中量表(NIHSS)评分水平,组间比较差异有统计学意义(P<0.05);无论单因素还是经相关变量校正的多变量Logistic回归分析,均显示脑干梗死与高水平SIGUT的发生显著相关(P<0.05)。结论应激性的血糖升高与脑干梗死密切相关,脑干梗死易于出现应激性的血糖升高且幅度越大。

Objective To investigate the relationship between the stress induced glucose up-regulation and brainstem infarction. Methods Three hundred and sixty-six patients of cerebral infarction in the department of neurology were included in this study. Stress induced glucose up-regulation was reflected by stress induced glucose up-regulation ratio (SIGUT), and the level of SIGUT was compared between groups of brainstem and non-brainstem infarction. SIGUT was categorized into 4 groups according to the quartiles, and relative variables were compared among 4 groups. The level-risk relationship between high level of SIGUT and brainstem infarction was performed through logistic regression. Results The level of SIGUT was higher in group of brainstem infarction than that in group of non-brainstem infarction: 1.060 ± 0.272 vs.1.159 ± 0.301(P=0.020). The percent of male, diabetes, brainstem infarction and level of FBG, HbA1c, NIHSS was obviously different in the 4 groups of SIGUT according to the quartiles (P < 0.05). High level of SIGUT was correlated to brainstem infarction in the single-factor or multivariable logistic regression adjusted for relative variable (P < 0.05). Conclusions Stress induced glucose up-regulation is correlated to the brainstem infarction, which is prone to happen in brainstem infarction, and the magnitude is more prominent.