高血糖与急性自发性脑出血患者预后的相关性分析

目的明确高血糖与急性脑出血患者预后的关系。方法回顾性分析了96例急性自发的脑出血（Intracerebralhemorrhage，ICH），收集了患者入院时的一般资料、病史、临床资料以及影像学特点等指标，采用格拉斯哥预后评分量表（GOS）评价患者出院时的预后评分，分为预后良好组（GOS4～5分）和预后不良组（GOS1～3分），早期的预后和临床特点之间的关联进行多因素logistic回归分析。结果96例患者中59例患者预后良好，占总人数的61．5％，37例预后不良，占46．6％。预后不良组为（9．534-2．03）mmol／L初始血糖明显高于预后良好组（6．64±1．33）mmoL／L（P〈0．001）。血糖≥7．8mmol／L，优势（OR）：25．217，P=0．008，和血肿的最大直径≥3cm（OR=216．422，P〈0．001）与不良预后独立相关。结论在急性自发性的ICH患者中，入院时高血糖（≥7．8mmol／L）和血肿的最大直径≥3cm是预后不良的强预测因素。

The correlation between hyperglycemia and prognosis of acute spontaneous cerebellar hemorrhage

Objective To probe into the correlation between hyperglycemia and progosis of acute spontaneous cerebellar hemorrhage. Methods A total of 96 cases of acute spontaneous ICH （intracerebral hemorrhage） were analyzed retrospectively including general inforrmtion of patients, medical history, clinical data and imaging features. And Glasgow Outcome Rating Scale （GOS） was used in the evaluation of patients at discharge and all the patients were divided into the good outcome group （ GOS 4 - 5） and the poor outcome group （ GOS 1 - 3 ）. The association between early outcome and clinical characteristics was analyzed by multivariate Logistic regression analysis. Results Among 96 patients, 59 patients got a good prognosis, accounting for 61.5%, and 37 cases got a poor prognosis, accounting for 46.6%. In poor outcome group （9.53 mmol/L ±2.03 mmol/L） initial blood glucose was significantly higher than that of good outcome group （6.64 mmol/L ± 1.33 mmol/L） （P 〈 0. 001 ）. Blood glucose ≥7. 8 mmol/L （odds ratio（OR） = 25. 217, P = 0. 008） and the maximum diameter of the hematoma I〉 3 cm （ OR = 216. 422, P〈0.001） were independently associated with the poor outcome. Conclusion In patients with acute spontaneous ICH, hyperglycemia at admission （ ≥7.8 mmol/L） and the maximum diameter of the hematoma ≥ 3 cm are the strong predictor for a poor prognosis.