不同血糖水平对急性脑梗死患者预后的影响研究

Study on effect of different blood glucose levels on prognosis of patients with acute cerebral infarction

目的 探析不同血糖水平对急性脑梗死患者预后的影响。方法 试验选取急性脑梗死患者60例作为对象,按照是否合并糖尿病划分为对照组和观察组,各30例,分别对应非糖尿病急性脑梗死患者、合并糖尿病急性脑梗死患者。两组患者入院后均进行相应的常规对症支持治疗,对比两组患者疗效、预后情况、神经功能及血糖波动情况。结果 观察组24 h平均血糖值、血糖水平标准差、平均血糖波动幅度、最大血糖波动幅度分别为(8.28±1.83)、(2.09±0.41)、(4.27±0.65)、(3.10±0.46)mmol/L,均高于对照组的(5.76±1.09)、(1.57±0.32)、(3.23±0.36)、(2.19±0.34)mmol/L,组间对比差异显著(P<0.05)。两组脑出血转化率组间对比无差异(P>0.05);观察组再通良好率及预后良好率分别为33.33%、30.00%,均低于对照组的63.33%、60.00%,组间对比差异显著(P<0.05)。两组治疗前美国国立卫生研究院卒中量表(NIHSS)评分对比无差异(P>0.05);治疗后,两组NIHSS评分均低于本组治疗前,但观察组NIHSS评分(10.78±2.14)分高于对照组的(8.10±1.57)分,对比差异显著(P<0.05)。观察组治疗总有效率73.33%低于对照组的96.67%,对比差异显著(P<0.05)。结论 血糖水平波动对急性脑梗死患者治疗及预后会产生一定不良影响,需要予以重视,在实际治疗中应积极控制血糖水平。

Objective To explore the effect of different blood glucose levels on prognosis of patients with acute cerebral infarction.Methods 60 patients with acute cerebral infarction were selected as subjects and divided into a control group and an observation group according to whether diabetes was combined or not,with 30 cases in each group,corresponding to non-diabetic patients with acute cerebral infarction and diabetic patients with acute cerebral infarction,respectively.After admission,the two groups of patients received corresponding routine symptomatic supportive treatment,and the efficacy,prognosis,neurological function and blood glucose fluctuation of the two groups were compared.Results The 24 h mean blood glucose,standard deviation of blood glucose,mean blood glucose fluctuation and maximum blood glucose fluctuation were(8.28±1.83),(2.09±0.41),(4.27±0.65)and(3.10±0.46)mmol/L in the observation group,which were higher than(5.76±1.09),(1.57±0.32),(3.23±0.36)and(2.19±0.34)mmol/L in the control group,and the difference between groups was significant(P<0.05).The difference in cerebral hemorrhage conversion rate between the two groups was not significant when compared between the groups(P>0.05).The excellent recanalization rate and excellent prognosis rate of the observation group were 33.33%and 30.00%,which were lower than 63.33%and 60.00%of the control group,and the difference between the groups was statistically significant in comparison(P<0.05).There was no significant difference in the score of National Institutes of Health Stroke Scale(NIHSS)before treatment between the two groups(P>0.05).After treatment,the NIHSS score of the two group was lower than that before treatment;the NIHSS score of the observation group was(10.78±2.14)points,which was higher than(8.10±1.57)points of the control group,and the difference was significant(P<0.05).The total effective rate of the observation group was 73.33%,which was lower than 96.67%of the control group,and the difference was significant(P<0.05).Conclusion Blood glucose fluctuation will have a certain adverse effect on the treatment and prognosis of patients with acute cerebral infarction,which should be paid attention to,and the blood glucose level should be actively controlled in the actual treatment.