不同强度降血糖对急性脑梗死后高血糖患者预后影响的研究

发布时间：2018-06-24 10:28

本文选题：急性脑梗死 + 高血糖　；参考：《中风与神经疾病杂志》2016年10期

【摘要】：目的通过观察伴有卒中后高血糖的急性脑梗死患者,初步探讨强化降血糖与标准降血糖对其预后的影响。方法纳入106例发病72 h内的颈内动脉系统脑梗死患者,随机分为将末梢血糖控制在6~8 mmol/L的强化降血糖组及将末梢血糖控制在8~10 mmol/L的标准降血糖组,各53例,均予以胰岛素控制血糖达72 h。随访3 m,主要终点事件为:7 d NIHSS评分,3 m mRS评分;次要终点事件为:3 m死亡率,3 m严重残疾率,低血糖发生率。结果两组间7 d NIHSS评分与3 m mRS评分均具有显著统计学差异(P0.05)。但两组间3 m死亡率,3 m严重残疾率,低血糖发生率均无显著统计学差异(P0.05)。结论对急性脑梗死后高血糖患者强化降血糖较标准降血糖能显著改善神经功能缺损评分,对轻中度患者获益更明显,但减少死亡及改善严重残疾不明显。
[Abstract]:Objective to investigate the effect of intensive hypoglycemia and standard hypoglycemia on the prognosis of patients with acute cerebral infarction with hyperglycemia after stroke. Methods 106 patients with cerebral infarction of the internal carotid artery system within 72 hours were randomly divided into two groups: enhanced hypoglycemic group with peripheral blood glucose control at 68 mmol / L and standard hypoglycemic control group with peripheral blood glucose at 8 mmol / L, 53 cases each. The blood glucose was controlled by insulin for 72 hours. Following up for 3 m, the main endpoint events were: 1 7 d NIHSS score and 3 m Mrs score, and the secondary endpoint events were 3 m severe disability rate and 3 m hypoglycemia rate at 1: 3 m mortality rate. Results the NIHSS score was significantly different from that of 3 mm Mrs score in 7 days (P0.05). However, there was no significant difference in 3 m mortality and 3 m severe disability rate and hypoglycemia rate between the two groups (P0.05). Conclusion intensive hypoglycemia in patients with hyperglycemia after acute cerebral infarction can significantly improve the score of neurological deficit, and benefit the patients with mild and moderate cerebral infarction, but the reduction of death and the improvement of severe disability are not obvious.
【作者单位】：南昌大学江西省人民医院神经内科江西省神经病学研究所;江西省妇幼保健院产前诊断科;
【基金】：江西省卫生计生委科技计划(No.20155072)
【分类号】：R743.33

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