高血糖影响脑梗死预后的随访研究

目的探讨高血糖对急性脑梗死患者预后及功能康复的影响。方法将2006—2008年入院的2319例急性脑梗死患者按照入院血糖水平分为高血糖组(入院血糖水平≥6.12mmol/L)和血糖正常组(入院血糖水平6.12mmol/L),采用定期随访观察的方法,对两组患者发病90d后的生存状态、神经功能评分(NIHSS、mRS)进行比较和分析。结果高血糖组急性脑梗死发病90d时的病死率(53.73%)高于血糖正常组(46.27%),差别有统计学意义(P0.05)。在发病90d后仍存活者中,高血糖组功能康复不良(mRS≥2)的比例(28.19%)高于血糖正常组(19.11%),差别有统计学意义(P0.05)。血糖正常组mRS≥2者的入院血糖水平(5.05±0.58)mmol/L]高于mRS2者(4.92±0.60)mmol/L],差别有统计学意义(P0.05)。结论高血糖增加脑梗死患者发病90天时的病死率,同时对其功能恢复也有不利影响。监测血糖水平对估计预后有重要意义。

The Effect of Hyperglycaemia on Prognosis after Ischemic Stroke

Objective To determine whether Hyperglycaemia influences outcome and increase stroke fatality rate after ischemic stroke. Methods 2 319 patients with acute ischemic stroke admitted to hospital during 2006 to 2008 were divided into normoglyeemia （〈6.12 retool/L） group and hyperglycaemia group （~〉 6.12 mmol/L） according to the levels of blood glucose. A regular follow-up study was used to analyze differences of the survival status, nerve function evaluation by National Institution of Health Stroke Scale （NIHSS） and Modified Rankin Scale （mRS） at the 90th day after stroke. Results The fatality rate in 90 days after ischemic stroke in hyperglycaemia group （46.27%） was higher than that in normoglycemia group （28.19%）. Among normoglycemia group,and the similar tendency occurred in rate of mRS t〉 2 among survival in 90 clays after stroke, it was 28.19% in hyperglyceamia group, 19.11% in normoglyceamia group. There appeared a higher average level of glucose among mRS ≥ 2 group （5.05±0.58） than mRS〈2 group （4.92±0.60）, P〈0.05. Conclusion Hyperglycaemia not only increased the fatality rate of ischemic stroke in 90 days, but also effected on the recovering of nervous system functions after stroke. It is very important for estimating prognosis to monitor the glucose level after stroke.