急性脑梗死时糖代谢特点

目的 :探讨急性脑梗死时血糖升高的原因及其对神经功能的影响。方法 :前瞻性分析 180例急性脑梗死患者空腹血糖(FBG)、胰岛素 (Ins)、胰岛素敏感指数的变化 (ISI) ,并分析其与脑梗死神经功能缺损和恢复的相关性。结果 :脑梗死急性期出现血糖水平升高者共 12 1例 ,85例为已确诊的糖尿病患者 ,11例为漏诊的糖尿病和糖耐量减低者 ,2 5例为一过性血糖升高的非糖尿病患者 ;一过性高血糖组恢复期的血糖水平较急性期明显下降 ,胰岛素水平则上升 ;糖尿病组急性期的胰岛素水平明显高于一过性高血糖组和血糖正常组 ;一过性高血糖组急性期的神经功能缺损较血糖正常组、糖尿病组严重 ,且其急性期血糖水平与其神经功能缺损评分呈正相关 ;结论 :急性脑梗死时血糖升高在非糖尿病患者和应激有关 ,其血糖升高程度与病变严重性相关。

Characteristics of Carbohydrate Metabolism of Acute Cerebral Infarction

Aim:To investigate the reasons of hyperglycemia at cerebral infarction present in patients,and the effect of hyperglycemia on neurological function.Methods:The study involved 180 patients hospitalized with acute cerebral infarction.The fast blood glucose,insulin,insulin sensitive index (ISI)and the neurologic impairment were measured.The relatonship between hyperglycemia and neurologic impairment was estimated by correlation analysis.Results:Hyperglycemia was found in 121 patients,in which with 85 diabetes patients,11 potential diabetes patients or patients of imparied glucose tolerance (IGT),25 transient hyperglycemia patients of nondiabetes.In the transient hyperglycemia group,the blood glucose level of convalescent period was lower than that of acute period,while the insulin level was higher.The neurologic impairment of the transient hyperglycemia group was more severe than that of the diabetes group or the normal-glycemia nondiabetes group.The degree of neurologic impairment was positive correlated with its blood glucose level of acute period.Conclusion:Hyperglycemia at ischemic stroke onset in patients was the result of stress in nondiabetic patients.The serum glucose level was positive correlated with the severity in transient hyperglycemia patients.