脑梗死后应激性高血糖对自主活动能力恢复的影响

目的探讨应激性高血糖对脑梗死患者自主活动能力恢复的影响及预测价值。方法对459例非糖尿病脑梗死患者临床资料进行回顾性分析,依据患者空腹血糖(FPG)水平分为未出现应激性高血糖组(空腹血糖<6.1 mmol/L),应激性血糖轻度升高组(6.1 mmol/L≤空腹血糖<7.0 mmol/L)和应激性血糖显著升高组(空腹血糖≥7.0 mmol/L)。统计数据包括患者年龄,既往病史,血生化、凝血系列化验结果,CT、磁共振影像学表现,日常生活活动量表(ADL)评分。数据分析采用PASW 18.0软件,以P<0.05为差异有统计学意义。结果年龄大于65岁,有房颤、高血压病史、甘油三酯水平高于正常的非糖尿病脑梗死患者出现应激性高血糖的风险增加。大脑半球梗死与应激性高血糖有关。同时FPG、凝血酶原时间活动度(PT%)、纤维蛋白原(Fib)、D-二聚体(D-Di)和血清尿素氮(BUN)五项检测指标与ADL评分结果密切相关。应激性血糖轻度升高组和应激性血糖显著升高组ADL评分低于未出现应激性高血糖组,应激性血糖显著升高组又低于应激性血糖轻度升高组。应激性高血糖水平与脑梗死患者活动障碍严重程度呈正相关性(rs=-0.264 3,P<0.000 1)。结论应激性高血糖的出现增加了脑梗死患者活动功能障碍的风险。

The influence of stress hyperglycemia on the recovery of daily living activity in stroke patients

Objective To analyze the influence and forecast value of stress hyperglycemia on the recovery of daily living activity in stroke patient.Methods The clinical data of 459 non-diabetics stroke patients was retrospectively analyzed.The patients were devide into three groups according to the fasting plasma glucose level.They were the euglycemia group(FBG<6.1 mmol/L),the mild stress hyperglycemia group(6.1 mmol/L≤FBG<7.0 mmol/L) and the severe stress hyperglycemia group(FBG≥7.0 mmol/L).The statistical data included age,diseases history,blood biochemistry test,blood coagulability and hemostatic function test,CT,MRI and Activities of Daily Living Assessment(ADL).PASW 18.0 was used for the statistical analysis and statistical significance was set at P<0.05.Results The risk of stress hyperglycemia was higher in senile patients(>65 years old) with atrial fibrillation,hypertension or hypertriglyceridemia.Cerebral hemispheric infarction was connected with stress hyperglycemia.At the same time,fasting plasma glucose(FBG).Prothrombin Time %(PT%).fibrinogen(Fib).D-dimer(D-Di) and blood urea nitrogen(BUN) were closely related to the ADL score.The ADL score of the mild stress hyperglycemia group and the severe stress hyperglycemia group was lower than that of the euglycemia group,while it was also lower in the severe stress hyperglycemia group than in the mild stress hyperglycemia group.Stress hyperglycemia was positively correlated with the high risk of activity disorder in stroke patients(rs=-0.264 3,P<0.000 1).Conclusions Stress hyperglycemia in patients with cerebral infarction increases the risk of daily living activity disorder.