急性脑卒中患者应激性高血糖的临床意义

目的研究急性脑卒中患者起病48h内血糖水平与脑卒中严重程度、卒中类型和预后的关系。方法测定300例无糖尿病史的急性脑卒中患者起病48h内的血糖水平。结果本组300例中,脑出血108例中发现应激性高血糖45例,占41.7%;脑梗死192例中出现应激性高血糖39例,占20.3%,脑出血应激性高血糖出现率显著高于脑梗死(P<0.01)。300例中,正常血糖组216例,死亡5例,占2.3%;高血糖组84例,死亡19例,占22.6%。高血糖组病死率显著高于正常血糖组(P<0.01)。216例血糖正常组中,重症8例,占3.7%;血糖升高组84例中,重症32例,占38.1%,两者相比具有显著性(P<0.01)。结论急性脑卒中无糖尿病史发生应激性血糖升高患者的血糖水平,可作为判断其症状、观察病情变化、判断预后的参考指标。

Clinical Study of Relationship between Acute Cerebral Ischemia Stroke and Stress Hyperglycemia

Objective To study the relationship between the neurological deficits ,type and prognosis of the acute cerebral ischemia stroke and the level of reactive hyperglycemia due to major stress within 48 h. Methods A consecutive series of 300 patients hospitalized of the acute cerebral ischemia stroke were retrospectively studied. The patients were divided into 3 groups according to the neurological deficits. The fasting blood sugar（FBS） were detected within 48 hours after hospitalization. The prognosis of the 300 patients were studied and discussed. Results A strong relation between the FBS levels and the neurological deficits after admission suggested that a reactive hyperglycemia due to a major stress response existed in acute stroke. There was also a significant relation between the FBS levels and short-term outcome. FBS had remarkable positive correlation with the poor prognosis,the extend of the neurological deficits. Conclusion The hyperglycemia after acute ischemia or hemorrhagic stroke was reactive phenomenon due to the major stress. The high FBS levels might have positive correlations with the extend of the neurological deficits,the poor prognosis.