糖尿病和糖耐量异常患者在急性缺血性脑血管病中的调查研究

目的 探讨糖尿病和糖耐量异常患者在急性缺血性脑血管病中的流行情况.方法 选择急诊内科病房及神经内科住院的115例短暂性脑缺血发作(TIA)、496例急性脑梗死患者进行空腹血糖、糖化血红蛋白检测,登记患者的临床资料,对既往未诊断糖尿病而空腹血糖在6.1～6.9 mmol/L的患者中进行口服葡萄糖耐量试验(OGTT),糖代谢分类采用2003年美国糖尿病学会建议标准.结果 611例急性缺血性脑血管病患者住院前糖尿病的诊断率18.8%,住院后系统检查发现糖尿病新的患病率45.0%,糖耐量异常18.6%;212例空腹血糖在6.1～6.9 mmol/L的患者中,OGTT发现其中33.5%患者可诊断为糖尿病,53.8%提示糖耐量异常.结论 63.8%的急性缺血性脑血管病患者合并糖尿病或糖耐量异常;空腹血糖在6.1～6.9 mmol/L的患者应常规做OGTT检查来筛查糖代谢异常患者.

Study of diabetes mellitus and impaired glucose tolerance among the patients with acute ischemic cerebrovascular disease

Objective To investigate the prevalence of diabetes mellitus and impaired glucose tolerance among the patients with ischemic cerebrovascular disease. Methods A survey was conducted among 611 inpatients with ischemic cerebrovascular disease in our department of Neurology including 115 patients with transient ischemic attack(TIA), and 496 patients with acute cerebral infarction(ACI). The fasting plasma glucose level and HbA1c were tested when all the patients were hospitalized. The patients were not diagnosed as diabetes with fasting plasma glucose level (6.1～6.9)mmol/L were examined by oral glucose tolerance test (OGTT). Results 18.8% of 611 inpatients with ischemic cerebrovascular disease had been previously diagnosed as diabetes. According to the fasting plasma glucose level and the OGTT results, we found that the prevalence rates of diabetes mellitus and impaired glucose tolerance were 45.0% and 18.6% respectively among all the inpatients. OGTT was used in 212 inpatients whose fasting plasma glucose levels were between 6.1 mmol/L and 6.9 mmol/L. 33.5% were diagnosed as diabetes and 53.8% impaired glucose tolerance. Conclusion The prevalence rates of diabetes and impaired glucose tolerance is 63.8% among the inpatients with ischemic cerebrovascular disease in all. OGTT can help us find new patients with diabetes or impaired glucose tolerance. Patients whose fasting plasma glucose levels are between 6.1mmol/L and 6.9mmol/L must be checked with OGTT.