急性期餐后高血糖对脑梗死患者近期预后的影响

目的:探讨餐后高血糖对急性期脑梗死患者病情严重程度及预后的影响。方法:检测101例急性期脑梗死患者的餐后血糖,将所有患者分为餐后高血糖组和餐后血糖正常组,分别对两组患者的神经功能康复状况进行跟踪观察。采用多变量Logistic回归分析餐后高血糖、高血压、高血脂、冠心病、年龄、性别、吸烟、饮酒等危险因素对终点事件的影响。结果:餐后血糖的水平与NIHSS呈正相关(r=0.327;P=0.001;Spearman′s相关),餐后高血糖组患者4周、12周及24周的NIHSS评分均高于餐后血糖正常组,有显著差异(P均<0.05)。多变量回归分析显示餐后高血糖与终点事件独立相关(OR7.772;95%CI1.075～56.189;P=0.042)。结论:餐后血糖增高不利于急性脑梗死患者神经功能的康复,其近期预后较餐后血糖正常者差;餐后高血糖可能是脑梗死患者死亡和再发缺血性血管病变的独立危险因素。

Postprandial hyperglycemia affects the short-term prognosis of acute cerebral infarction

Objective ： To examine the extent of seriousness of postprandial hyperglycemia in patients with acute cerebral infarction and the shortterm effect on prognosis. Methods：One hundred and one patients with cerebral infraction received postprandial hyperglycemia determination and were allocated to groups of postprandial hyperglycemia and normal postprandial glucose. The two groups of patients were followed up with regard to nerve function recovery. The multiple logistic regression analysis was used to evaluate the association between the risk factors and the outcome in terms of hyperglycemia after meal,hypertension, hyperlipemia, coronary heart disease,ages, sexes, history of smoking and drinking. Results ： The postprandial glucose level was positively correlated with the scores by National Institutes of Health Stroke Scale （ NIHSS ） estimation （ r = 0. 327 ; P =0. 001 ;Spearman cmTelation）. At 4 th, 12 th and 24 th week after cerebral infraction, the scores by NIHSS in the group with postprandial hyperglycemia were higher than those of the group with normal postprandial glucose, which was significantly different（ P 〈 0.05 ）. The multiple logistic regression analysis revealed that higher postprandial glucose could serve as an independent predictor of death or new vascular event （ OR 7. 772 ;95% CI 1. 075 - 56. 189 ; P = 0. 042 ）. Conclusion ： Postprandial hyperglycemia may act negatively to the neurofnnction rehabilitation for patients with acute cerebral infarction and probably result in poor outcome of the prognosis. Besides, it might be an independent predictor of death or new vascular event.