2型糖尿病合并急性脑梗死患者高血糖对预后的影响

目的 探讨2型糖尿病合并急性脑梗死患者高血糖对预后的影响.方法 将360例2型糖尿病合并急性脑梗死患者作为观察组,并同期选取住院的200例非糖尿病急性脑梗死患者为对照组.治疗前及治疗后1年采用改良Barthel指数评估患者日常生活能力(ADL),采用Fugl-Meyer运动功能评定量表(FMA)评定肢体运动功能.比较两组住院期间病死率、出院1年复发率及MBI、FMA评分.结果 观察组住院期间病死率为14.7%,显著高于对照组6.5%(P=0.004);观察组与对照组出院1年复发率分别为27.2%和5.0%,差别具有统计学意义(P=0.000).观察组高血糖患者(>7.0 mmol/L)病死率及复发率均显著高于正常血糖患者(P=0.025,P=0.000);治疗后对照组MBI及FMA评分显著优于观察组(P=0.000).结论 2型糖尿病合并急性脑梗死患者病情重,预后差,高血糖水平可加重糖尿病合并脑梗死患者病情,肢体功能及日常生活能力恢复差.

Study on influence of hyperglycemia on prognosis of patients with diabetes complicated with acute cerebral infarction

Objective To explore the influence of hyperglycemia on prognosis of patients with diabetes complicated with cerebral infarction.Methods Three hundred and sixty patients with diabetes complicated with acute cerebral infarction were assigned to experimental group,and 200 patients with acute cerebral infarction were allocated into control group.Modified Barthel index（MBI） and Fugle-Meyer Movement Assessment（FMA） scores were used to evaluate activities of daily living（ADL） and motor function of extremities in patients before and after treatment.The mortality during hospitalization,recurrence rate at 1 year after discharge,MBI and FMA scores were compared between these two groups.Results The mortality during hospitalization in experimental group was much higher than that of controls（14.7% vs 6.5%,P=0.004）.Their recurrence rates at 1 year after discharge were 27.2% and 5.0% respectively,their difference was significant（P=0.000）.The mortality and recurrence rate in patients of experimental group with hyperglycemia were much higher than those of patients with normal blood glucose level（P=0.025,P=0.000）.MBI and FMA scores in control group were much better than those of experimental group（P=0.000）.Conclusion Patients with diabetes complicated with acute cerebral infarction are characterized by severe condition and bad prognosis.Hyperglycemia has a close relationship with worse condition of the disease and poor ADL and motor function of extremities.