血糖水平对急性缺血性脑卒中后认知功能障碍及神经功能缺损的影响

Effects of Blood Glucose Level on Cognitive Dysfunction and Neurological Deficit after Acute Ischemic Stroke

目的探究血糖水平对急性缺血性脑卒中(acute ischemic stroke,AIS)后认知功能障碍及神经功能缺损的影响。方法回顾性分析2019年3月—2020年3月曹县人民医院收治的136例AIS患者的临床资料,根据患者空腹血糖值分为高血糖组(A组,62例)与正常血糖组(B组,74例),采用简易智力状态检查量表和蒙特利尔认知评估量表评价患者认知功能,采用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评定神经功能、mRS量表(Menopause Rating Scale,mRS)评定预后。结果A组患者入院时、出院时MMSE(13.61±3.18)分、(17.61±5.69)分,MoCA量表评分(12.45±3.36)分、(16.83±5.37)分均显著低于B组(16.36±3.44)分、(20.72±7.21)分、(14.67±4.29)分、(21.33±3.79)分,差异有统计学意义(t=4.805、2.753、3.311、5.710,P<0.05)。A组患者入院时NIHSS、mRS量表评分(11.39±2.51)分、(4.32±1.56)分均显著高于B组(7.31±1.42)分、(3.11±1.02)分,且出院时NIHSS、mRS量表评分(6.45±2.33)分、(2.38±1.13)分均显著高于B组(4.89±1.64)分、(1.90±0.51)分,差异有统计学意义(t=11.899、5.431、4.431、3.090,P<0.05)。结论血糖水平是影响AIS患者认知及神经障碍的重要因素,高血糖水平的AIS患者认知功能及神经功能损伤程度较大,预后较差。

Objective To investigate the effect of blood glucose level on cognitive dysfunction and neurological deficit after acute ischemic stroke(AIS).Methods The clinical data of 136 AIS patients admitted to the Caoxian People’s Hospital from March 2019 to March 2020 were retrospectively analyzed.The patients were divided into hyperglycemia group(group A,62 cases)and normal blood sugar group(group B,74 cases)according to the fasting blood glucose value.The cognitive function of the patients was evaluated by the Mini-Mental State Examination Scale and the Montreal Cognitive Assessment Scale.The National Institute of Health Stroke Scale(NIHSS)was used to assess neurological function and the mRS scale(mRS)was used to assess prognosis.Results The scores of MMSE(13.61±3.18)points,(17.61±5.69)points,and MoCA scale scores(12.45±3.36)points and(16.83±5.37)points of patients in group A were significantly lower than those in group B(16.36±3.44)points,(20.72±7.21)points,(14.67±4.29)points;(21.33±3.79)points at admission and discharge,the differences were statistically significant(t=4.805,2.753,3.311,5.710,P<0.05).The scores of NIHSS(11.39±2.51)points and mRS(4.32±1.56)points of patients in group A at admission were significantly higher than those of group B(7.31±1.42)points and(3.11±1.02)points,and the NIHSS and mRS scale scores(6.45±2.33)points and(2.38±1.13)points of patients in group A at discharge were significantly higher than those in group B(4.89±1.64)points and(1.90±0.51)points,and the difference was statistically significant(t=11.899,5.431,4.431,3.090,P<0.05).Conclusion Blood glucose level is an important factor affecting the cognitive and neurological impairment of AIS patients.AIS patients with high blood glucose level have a greater degree of cognitive and neurological impairment and poor prognosis.