2型糖尿病合并缺血性脑卒中患者采用强化降糖方案治疗的临床效果

Clinical effect of intensive hypoglycemic regimens in the treatment of patients with diabetes mellitus type 2 complicated with ischemic stroke

目的观察2型糖尿病合并缺血性脑卒中患者采用强化降糖方案治疗的临床效果。方法选取2019年5月至2020年1月新疆医科大学第七附属医院收治的2型糖尿病合并缺血性脑卒中患者共100例,根据糖化血红蛋白情况分为将其分为强化组(糖化血红蛋白>9.0%,50例)和对照组(糖化血红蛋白≤9.0%,50例)。强化组给予持续皮下胰岛素输注治疗,出院后调整为多次皮下注射胰岛素,对照组口服降糖药物治疗3个月后,如糖化血红蛋白≥7.0%,则调整治疗方案直至糖化血红蛋白<7.0%。两组治疗时间均为6个月。比较两组入院时与治疗6个月后的生化指标,比较两组治疗6个月后的神经功能情况。结果强化组治疗6个月后空腹血糖、餐后2 h血糖、糖化血红蛋白、同型半胱氨酸水平均低于入院时,对照组餐后2 h血糖、同型半胱氨酸水平均低于入院时,差异均有统计学意义(P<0.05)。强化组入院时餐后2 h血糖、糖化血红蛋白水平均高于对照组,差异均有统计学意义(P<0.05)。强化组治疗6个月后空腹血糖、餐后2 h血糖均高于对照组,肌酐低于对照组,差异均有统计学意义(P<0.05)。两组治疗6个月后的神经功能情况比较,差异有统计学意义(P<0.05)。结论糖尿病患者发生脑卒中后采用强化降糖干预手段,可改善神经功能恢复情况。

Objective To observe the effect of intensive hypoglycemic regimens in the treatment of patients with diabetes mellitus type 2 complicated with ischemic stroke.Methods A total of 100 patients with diabetes mellitus type 2 complicated with ischemic stroke admitted to the Seventh Affiliated Hospital of Xinjiang Medical University from May 2019 to January 2020 were selected and divided into the enhanced group(glycosylated hemoglobin>9.0%,50 cases)and the control group(glycosylated hemoglobin≤9.0%,50 cases)according to the glycosylated hemoglobin condition.Continuous subcutaneous insulin infusion was given to the intensive group,which was adjusted to multiple subcutaneous insulin injections after discharge.After three months of oral hypoglycemic drug treatment in the control group,if glycosylated hemoglobin≥7.0%,the treatment plan was adjusted until glycosylated hemoglobin<7.0%.The treatment time of both groups was six months.Biochemical indexes were compared between the two groups at admission and after six months of treatment,and neurological function was compared between the two groups after six months of treatment.Results After six months of treatment,the levels of fasting blood glucose,two hours postprandial blood glucose,glycated hemoglobin,and homocysteine in the enhanced group were lower than those at admission,while the levels of two hours postprandial blood glucose and homocysteine in the control group were lower than those at admission,with statistical significance(P<0.05).The levels of two hours postprandial blood glucose and glycosylated hemoglobin in the enhanced group were higher than those in the control group at admission,with statistical significance(P<0.05).After six months of treatment,fasting blood glucose and two hours postprandial blood glucose in the enhanced group were higher than those in the control group,and creatinine was lower than those in the control group,the differences were statistically significant(P<0.05).After six months of treatment,the neurological function was compared between two groups,and the difference was statistically significant(P<0.05).Conclusion Intensive hypoglycemic regimens can improve the recovery of neurological function in patients with diabetes after stroke.