脑卒中后血糖升高机制探讨

目的研究脑卒中血糖升高机制.方法采用葡萄糖氧化酶法测定血糖和微栓柱法测定GhbA1c,采用放射免疫法测定血皮质醇(COR)、胰岛素(INS)、胰高血糖素(GCG)及促肾上腺皮质激素(ACTH).卒中组与对照组均数比较采用t检验作对比分析.结果脑卒后高血糖组血ACTH,COR和GCG及INS升高;病灶位于基底节者高血糖及ACTH升高比例均高于非基底节者.结论脑卒中后血糖升高与交感-肾上腺和垂体-肾上腺系统活化及继发血中ACTH,COR和GCG等激素水平升高有关,也与病灶位于基底节区有关.对卒中后血糖升高患者应及时应用胰岛素控制应激性高血糖状态,对颅内高压脑水肿者给予脱水剂减轻对下丘脑的影响,避免进一步加重高血糖和脑损害.

Research on the mechanism of blood sugar going up after cerebral apoplexy

Objective: Studying the mechanism of the blood sugar going up after cerebral apoplexy. Method: Measuring blood sugar using glucose oxidase technique,measuring GhbA1 using micro-embolus pillar technique, measuring COR, INS GCG and ACTH using radio-immunity technique. The mean value comparison of apoplexy group and comparison group is made by means of texamination method. Results: In the high sugar blood group, in the blood ACTH, COR, GCG and INS goes up after cerebral apoplexy; the rising scale of sugar and ACTH for those whose focus lies in the basal ganglia is higher than non- basal ganglia?Conclusions: Blood sugar going up after cerebral apoplexy and activation of the sympathetic-adrenal and the pituitary-adrenal system relate to the fact that hormone level rises such as ACTH, COR, GCG and the focus lies in the basal ganglia section. The stress high blood status should be controlled in time using insulin for those patient whose blood sugar goes up after cerebral apoplexy. For the patients with increased intra-cranial pressure, dehydration should be used to alleviate the infection on the hypothalamus to avoid further aggravating high blood sugar and brain injury.