急性出血性卒中患者入院血糖水平对出院后短期不良结局的影响

Influence of Admission Blood Sugar Level of Acute Hemorrhagic Stroke Patients on Short-term Adverse Outcomes after Discharge

目的探讨急性出血性卒中患者入院空腹血糖水平对出院后不良结局的影响,为急性出血性卒中的治疗及二级预防管理提供科学依据。方法采用回顾性队列研究方法,选取完成随访的急性出血性卒中患者157例,收集一般资料、实验室指标等,出院6个月后采用改良Rankin量表(mRS)对患者进行评分。结果急性出血性卒中患者入院时血糖正常组(<6.1 mmol·L^(-1))、空腹血糖受损组(6.1~6.99 mmol·L^(-1))、糖耐量减低组(7.0~10.0 mmol·L^(-1))和血糖中重度升高组(>10.0 mmol·L^(-1))的比例分别为29.3%、17.2%、27.4%和26.1%。患者出院后6个月mRS评分平均为(2.79±2.48)分,不良结局比例为47.7%。入院血糖水平为7~10.0 mmol·L^(-1)组和10.0 mmol·L^(-1)以上的患者出院后6个月不良结局发生率是入院血糖水平正常患者的4.52倍(95%CI为1.81~11.34)和4.98倍(95%CI为1.96~12.68)。结论急性出血性卒中患者入院时空腹血糖水平升高增加了其出院后短期不良结局的风险,需要关注该类患者入院血糖水平,以改善预后。

Objective To explore the impact of the fasting blood glucose(FPG)level of patients with acute hemorrhagic stroke on the adverse outcomes after discharge,and provide scientific basis for the treatment and secondary prevention management of acute hemorrhagic stroke.Methods A retrospective cohort study was conducted in 157 patients with acute hemorrhagic stroke who completed the follow-up.The general data and laboratory indexes were collected.Six months after discharge,m RS was used to score the patients.Results The proportion of group with blood glucose level of 0-6.1 mmol·L^(-1),6.1-6.99 mmol·L^(-1),7.0-10.0 mmol·L^(-1) and above 10 mmol·L^(-1) were 29.3%,17.2%,27.4%and 26.1%.Modified Rankin’s Scale(m RS)was(2.79±2.48)after 6 months.The propotion of adverse outcomes was 47.7%.The results of multi-factor logistics regression analysis showed that the incidence of adverse outcomes at 6 months after admission in the group with blood glucose level of 7-10.0 mmol·L^(-1) was 4.52 times higher than that in the group with normal blood glucose level of admission(95%CI:1.81-11.34),and 4.98 times higher than that in the group with above10.0 mmol·L^(-1)(95%CI:1.96-12.68).Conclusion The increased level of FPG in patients with acute ischemic stroke on admission increases the risk of short-term adverse outcomes after discharge,and it is urgent to pay attention to the level of FPG in patients with acute ischemic stroke on admission to comprehensively improve their prognosis.