原发性脑出血急性期引起高血糖的机制及影响

目的:探讨原发性脑出血(Pri mary Intracerebral hemorrhage ,PICH)急性期高血糖的发生机制及其对预后的影响。方法:128例原发性脑出血急性期患者,详细了解病史后体检并记录其影像学特征,检测空腹静脉血浆血糖、胰岛素并计算胰岛素敏感指数(Insulin sensitivity index,ISI)。所有统计方法都采用SPSS 10 .0软件。结果:高血糖组空腹胰岛素水平高于非高血糖组(P<0 .001) ,高血糖组胰岛素敏感指数较非高血糖组低(P=0 .010) ,中线移位与否对血糖的影响有显著性差异(P=0 .003) ,高血糖和非高血糖组死亡率有显著性差异(P=0 .013)。结论:原发性脑出血急性期高血糖的发生与应激、高胰岛素血症、胰岛素抵抗和中线移位等有关,高血糖提示预后不良,积极控制高血糖,有助于减少急性期死亡率。

The mechanism and effect of hyperglycemia in primary intracerebral hemorrhage acute stage

Object: To investigate the mechanism and effect of hyperglycemia in primary intracerebral hemorrhage(PICH) acute stage. Methods: 128 patients suffering from ICH were involved.The patient history,imageology,the level of plasma glucose and insulin in fasting condition,insulin sensitivity index(ISI) were detected.The data were analyzed by SPSS10.0. Result: The plasma fasting insulin level of the hyperglycemia group is higher than that of non-hyperglycemia group significantly,while the insulin sensitivity index(ISI) of the hyperglycemia group is lower than that of non-hyperglycemia group.The midline shift had significant effect on hyperglycemia.There is a significant difference between the mortality of hyperglycemia group and that of non-hyperglycemia group. Conclusion: The mechanisms of hyperglycemia in primary intracerebral hemorrhage acute stage is related with stress,high plasma insulin,insulin resistance and midline shift.Hyperglycemia implies unfavourable prognosis.To control blood glucose is helpful to minimize the mortality of PICH in acute stage.