胰岛素强化治疗对急性脑梗死伴高血糖患者预后的影响

目的 观察胰岛素强化治疗对急性脑梗死伴高血糖患者的血清CRP与预后的影响.方法 162例急性脑梗死伴高血糖患者随机分成2组,治疗组81例给予胰岛素强化治疗,使血糖控制在4.4～6.1 mmol/L,对照组81例给予常规胰岛素治疗,血糖控制在10.0-11.7 mmol/L,观察2组患者血清CRP的变化及预后.结果 强化治疗组CRP较正常治疗组明显下降[(14.68±1.36)ms/L与(19.06 ±2.24)mg/L,P＜0.05],感染发生率明显低于常规治疗组(18.71%与33.65%,P＜0.05).神经系统功能恢复好于常规治疗组(第15天CCS评分别为72.16 ±2.31与58.13 ±2.07,第28天CCS评分别为76.42 ±2.14与67.07 ±1.99,P均＜0.05).结论 胰岛素强化治疗可降低急性脑梗死伴高血糖患者血清CRP与感染率,有助于神经系统功能恢复.

Prognostive effects of intensive insulin therapy on acute cerebral infarction patients with hyperglycemia

Objective To observe the influence of intensive insulin therapy on CRP and the indexes of prognosis in acute cerebral infarction patients with hyperglycemia.Methods 162 acute cerebral infarction patients with hyperglycemia were randomly divided into two groups.One group(n=81)received intensive insulin therapy,the blood glucose levels were controlled between 4.4 to 6.1 mmol/L.While the other group(n=81)received routine insulin therapy and the blood glucose levels were controlled between 10.0 to 11.7 mmol/L.The changes of CRP and the indexes of prognosis were observed in two groups.Results In the intensive insulin therapy group,the CRP level 0.05)were significantly decreased and the assessment scale of nervous system function was increased than those in the control group(72.16±2.31 vs 58.13 ±2.07 on the 15th day and 76.42±2.14 vs 67.07 ±1.99 on the 28th day,P＜0.05).Conclusion Intensive insulin therapy might decrease the CRP level and the rate of infection,and would be helpful to the recovery of nervous system function in the patients with acute cerebral infarction and hyperglycemia.