血糖水平对急性颅脑损伤预后影响的研究

目的:研究血糖水平对急性颅脑损伤预后的影响,探讨急性颅脑损伤后最佳血糖浓度。方法:研究急性颅脑损伤病人GCS评分、死亡率与血糖浓度的关系和平均血糖浓度与总体疗效的关系,探讨急性颅脑外伤后病人的最佳血糖浓度。结果:GCS评分低于8分者高血糖的发生率明显高于GCS评分高于8分者(P<0.05)。急性颅脑损伤预后与平均血糖浓度负相关。急性颅脑损伤病人伤后血糖的最佳浓度为5～6mmol/L。结论:急性颅脑损伤后血糖水平能够作为判定病人伤情及预后的一个指标。伤者越重,血糖浓度越高,其预后愈差。伤后最佳血糖浓度为5～6mmol/L。对于颅脑外伤的病人,应视血糖水平尽早给予一定量的胰岛素,以预防控制高血糖,可能有助于改善预后。

A Study of Effect of Blood Sugar on the Prognosis of Acute Cerebral Injury

Objective:To study the effect of blood sugar to the prognosis of acute cerebral injury and explore the best blood glucose concentration (BGC) after acute cerebral injury.Methods:The study was focused on the relation between blood glucose concentration (GCG) and GCS scores,and the relation between the mean blood glucose concentration (MBGC) and the total treatment effect.The best BGC after acute cerebral injury was explored. Results: The incidence of hyperglycemia(HG) was higher in lower GCS scores groups ( GCS < 8) than that in higher GCS scores groups ( GCS >8)(P<0.05). The death rate of patients with hyperglycemia was higher than that of the patients without hyperglycemia( P < 0.05) .The total treatment effect was negatively related to the MBGC.The best BGC was 5 - 6mmol/L after acute cerebral injury. Conclusion: The BGC after acute cerebral injury may be one of the indexes of acute cerebral injury. The higher the BGC is, the more severe the cerebral injury is , and the worse the total treatment effect is. It would be useful to limit the glucose intake and give the patients certain dose of insulin to prevent and control HG.