糖化血红蛋白水平与糖尿病性急性脑梗死患者预后的相关分析

目的探讨糖化血红蛋白（HbA1c）水平与糖尿病性急性脑梗死患者病情严重程度及预后的关系。方法收集2013年3月至11月在我院神经内科住院的合并糖尿病的急性脑梗死患者（发病72h内）142例，所有患者均行头颅MRI检查明确诊断。根据入院后检测的HbA1c水平将患者分为3组。Ⅰ组：HbA1c〉9．0％：Ⅱ组：7．0％〈HbA1c≤9．0％；Ⅲ组：HbA1c≤7．0％。所有患者于人院后24h内及出院3个月后采用美国国立卫生院卒中评分（NIHSS）评定患者的病情严重程度，用Barthel生活指数（BI）评定患者的日常生活能力，用改良的Rankin量表（mRS）评定患者的病残程度。结果入院后3组患者的NIHSS评分结果比较，差异有统计学意义（P〈0．05）。3个月后随访结果示3组NIHSS评分均较入院时明显下降，差异有统计学意义（P〈0．05）。Ⅰ组预后不良率为37．5％（18／48），Ⅱ组为31．4％（16／51），Ⅲ组为20．9％（9／43），3组之间比较差异有统计学意义（P〈0．05）。结论糖尿病性急性脑梗死患者的HbA1c水平能反映病情严重程度及预后。

A correlative study of the level of HbAlc and the prognosis of diabetic patients with acute cerebral infarction

Objective To investigate the correlation between the levels of HbAlc and the severity and prognosis of diabetic patients with acute cerebral infarction. Methods From March 2013 to November 2013, 142 diabetic patients were admitted to our hospital within 72 hours after acute cerebral infarction and then diagnosed by cerebral MRI. The patients were divided into three groups according to their levels of HbAlc at admission： HbAlc 〉 9.0% for Group Ⅰ ; 7.0% 〈 HbAlc≤9.0% for Group Ⅱ ; HbAlc≤7.0% for Group Ⅲ. The severity of the patientg condition, their daily living abilities and disabilities were assessed using National Institute of Health stroke scale （NIHSS）, the Barthel ADL index （BI） and modified Rankin scale （mRS） 24 hours respectively after admission and during follow - up visits three months after discharge. Results Significant differences were observed as to the NIHSS scores of three groups （P 〈 0.05 ）. The scores were remarkably reduced three months after discharge （ P 〈 0.05 ）. The percentage of poor prognosis was 37.5% （18/48） for group Ⅰ , 31.4% （ 16/51 ） for group Ⅱ and 20.9% （9/43） for group Ⅲ, indicating statisti- eal differences （P 〈 0.05 ）. Conclusion The severity and prognosis of diabetic patients with acute cerebral infarction are positively related with the level of HbAlc.