高血糖与急性脑梗塞的关系

将97例老年急性脑梗塞患者根据病史和入院3天内血糖测定分为糖尿病组、非糖尿病血糖升高组和非糖尿病血糖正常组。前二组又按血糖水平分为血糖轻度升高和血糖显著升高两种,然后对三组患者的临床症状、体征、脑CT改变及预后等进行对比分析。结果表明:急性脑梗塞患者,无论是糖尿病或是应激性高血糖引起的显著血糖升高者,均可使临床症状和肢体瘫痪加重,大面积梗塞和严重并发症增多,脑机能恢复不良和病死率增高;而糖尿病组和轻度血糖升高者仅造成病死率增高和脑机能恢复不良。提示血糖水平可作为急性脑梗塞患者预后的指标。

Relation between hyperglycemia and acute cerebral infarction

97 cases of acute cerebral infarction in the aged people were divided into three groups: diabetes, non-diabetes with hyperglycemia and non-diabetes with normal glycemia according to the histories and the glycemia measured within 3 days after admission. The first two groups were subdivided into two subgroups: moderate hyperglycemia and markedly high hyperglycemia according to the glycemia levels. The clinical symptoms and signs, the changes of brain CT and the prognosis of the patients in the two subgroups were analysed and compared. The results demonstrated that in the patients with acute cerebral infarction with high hyperglycemia caused by either diabetes or irritable hyperglycemia, the clinical manifestation and limb paralysis became deteriorated, the infarction area was enlarged, the cerebral function recovered imperfectly and severe complications and mortality increased; but in the patients with morderate hyperglycemia and diabetes, only the mortality increased and the cerebral functions recovered imperfectly(P<0.001). The mechanism of hyperglycemia resulting in poor prognosis of the patients was discussed. It was suggestod that glycemia level might be used as a predictor for the prognosis of acute cerebral infarction.