脑出血急性期血糖升高与患者胰岛素敏感性的关系

目的探讨高血压性脑出血急性期血糖升高患者是否存在胰岛素抵抗现象。方法将84例高血压性脑出血患者,以急性期血糖值分为血糖升高组和血糖正常组各42例;治疗1个月后测定其糖耐量试验前及后30、60、120、180min时血糖(BG)、血胰岛素(Ins)水平,计算其胰岛素敏感性指数(ISI)和神经功能缺损评分(NDS)。结果服糖后30、60min时血糖升高组的BG(10.76±2.41、9.51±0.94mmol/L)比血糖正常组(8.25±1.64、7.13±0.28mmol/L)高(P<0.05);血糖升高组的空腹Ins水平(12.37±11.25mmol/L)比血糖正常组(8.76±12.13mmol/L)高(P<0.05),服糖后30、60、120、180min时血糖升高组的Ins水平(96.42±30.58、83.64±24.05、74.63±20.46、35.48±11.32mmol/L)均明显高于血糖正常组相应时段的Ins(57.34±21.34、46.31±17.52、39.37±14.32、20.14±7.28mmol/L)水平(P<0.01);血糖升高组空腹ISI(-1.82±0.74)则低于血糖正常组(-1.34±0.56)(P<0.05),服糖后30、60、120、180min时血糖升高组的ISI(-3.45±1.59、-2.97±1.34、-2.74±1.05、-2.24±0.65)均低于血糖正常组相应时段的ISI(-2.97±1.25、-2.65±1.07、-2.36±0.84、-1.87±0.58)(P<0.05)。治疗30d后血糖升高组的NDS(23.16±10.78)高于血糖正常组(19.43±11.26)(P<0.05)。?

Hyperglycemia of patients with acute hypertensive intracerebral hemorrhage and insulin sensitivity

Objective To determine whether there is or not insulin resistance in hyperglyemic patients of acute hypertensive intracerebral hemorrhage.Methods The84cases with acute hypertensive intracerebral hemorrhage were selected,42cases of high fasting blood glucose(FBG)as hyperglycemia group(HG),other42cases of normal FBG as normal blood glucose group(NBG).The blood glucose(BG),insulin levels(Ins)and insulin sensitivity index(ISI)were measured by using oral glucose tolerance test(OGTT).Neurological deficidency score (NDS)was assessed later one month after treatment.Results The HG group (10.76±2.41,9.51±0.94mmol/L)had a higher BG than the NBG group (8.25±1.64,7.13±0.28mmol/L)after oral glucose30,60min in30days after being treated(P<0.05).The HG group(12.37±11.25mmol/L)had a higher fasting Ins than the NBG(8.76±12.13mmol/L)in30days after being treated(P<0.05).The HG group (96.42±30.58,83.64±24.05,74.63±20.46,35.48±11.32mmol/L,respectively)had significantly higher Ins than the NBG group (57.34±21.34,46.31±17.52,39.37±14.32,20.14±7.28mmol/L,respectively)after oral glucose30,60,120,180min in30days after being treated(P<0.01).The HG group(-1.82±0.74)had a lower fasting ISI than the NBG group(-1.34±0.56)in30days after being treated(P<0.05).The HG group (-3.45±1.59,-2.97±1.34,-2.74±1.05,-2.24±0.65,respectively)had a lower ISI than the NBG group (-2.97±1.25,-2.65±1.07,-2.36±0.84,-1.87±0.58,respectively)after oral glucose30,60,120,180min in30days after being treated(P<0.05).The HG group(23.16±10.78)had a higher NDS than the NBG group (19.43±11.26)in30days after being treated (P<0.05).Conclusion In hyperglycemic patients with acute hypertensive intracerebral hemorrhage there are hyperinsulinemia,insulin resistance and bad outcome.