糖尿病患者发生脑卒中后血糖控制水平与临床疗效及预后的相关研究

The Therapeutic Effect and Prognosis Research of Diabetes Stroke Patients in Different Blood Glucose Control Level

目的:观察2型糖尿病患者发生脑卒中后不同的血糖控制水平与其临床疗效及预后的差异。方法:本研究采用前瞻性的研究方法,选取2013年以来在我院神经内、外科及内分泌科住院的脑卒中患者205例,所有患者既往均有2型糖尿病病史;入院后均给予胰岛素静脉泵入控制血糖,根据血糖的控制水平分为两组:强化组及对照组;强化组将血糖控制在7. 8mmol/L以下,对照组将血糖控制在10mmol/L以下;观察两组患者住院期间肺部感染、颅内水肿消退时间、尿路感染、癫痫、深静脉血栓形成及肾功能衰竭的发生情况。所有患者于发病后第14天行美国国立卫生院神经功能缺损评分(NIHSS评分),发病后3个月门诊随访行改良Rankin量表(mRS评分)评分。结果:住院期间两组患者肺部感染、尿路感染、癫痫、深静脉血栓形成及肾功能衰竭的发生例数相比差异无统计学意义(P>0. 05),颅内水肿消退时间差异无统计学意义(P>0. 05);两组患者于发病后第14天NIHSS评分差异无统计学意义(P>0. 05),发病后3个月mRS评分差异无统计学意义(P>0. 05)。结论:糖尿病患者脑卒中发生后,血糖水平控制在10mmol/L以下和7. 8mmol/L以下临床疗效及预后差异无统计学意义。

Objective: Observing the therapeutic effect and prognosis of different blood glucose control level in 2 diabetes patients who get cerebral stroke. Methods: This research adopt prospective method;choosing 205 cerebral stroke patients who have 2 diabetes in neurology,neurosurgical and our departments between 2013 and now;when they enter the hospital,checking the glucose and GCS,we control the glucose by insulin pump. The enhanced group’glucose is below 7. 8 mmol/L,the control group’glucose is below 10 mmol/L. We observe the pulmonary infection,intracranial edema duration,urinary tract infection,epilepsy,deep vein thrombosis,renal failure rate in hospitalization. To evaluate NIHSS 14 days after hospitalization,mRS three months after hospitalization. Results: The pulmonary infection,intracranial edema duration,urinary tract infection,epilepsy,deep vein thrombosis,renal failure rate between the two groups have no difference( P>0. 05);NIHSS 14 days after hospitalization,mRS three months after hospitalization between the two groups have no difference( P>0. 05). Conclusion: When the 2 diabetes patients get cerebral stoke,the blood glucose control level below 10 mmol/L and 7. 8 mmol/L has on influence on the incidence of complications during hospitalization and the prognosis of patients.