糖尿病合并急性期脑卒中患者血糖变异性与短期不良预后的相关性

发布时间：2018-03-27 06:17

本文选题：糖尿病　切入点：脑卒中　出处：《中国糖尿病杂志》2017年01期

【摘要】：目的探讨糖尿病合并急性期脑卒中患者血糖变异性与短期不良预后的相关性。方法选取糖尿病合并急性期脑卒中患者155例,根据血糖水平标准差(GluSD)分为血糖变异组(GluSD≥1.4mmol/L)92例和非血糖变异组(GluSD1.4mmol/L)63例。另根据GluSD水平将血糖变异组进行三分位分组,从低到高分别为低分位(GluSD 1.42~1.87mmol/L)组、中分位(GluSD 1.43~2.32mmol/L)组及高分位(GluSD 2.33~2.87mmol/L)组。各组入院后均接受72h动态血糖监测(CGM),计算CGM指标,以美国国立卫生院卒中(NIHSS)评分、蒙特利尔认知评估量表(MoCA)及Barthel指数评估短期内的预后状况。采用Logistic回归分析糖尿病合并急性期脑卒中患者短期不良预后的影响因素。结果血糖变异组FPG[(8.49±1.71)vs(7.33±1.58)mmol/L]、HbA_1c[(8.61±0.55)%vs(7.14±0.43)%]、GluAve、GluMAGE、GluGLI及GluCV均高于非血糖变异组(P0.05或P0.01);高分位组GluAve、GluMAGE、GluGLI及GluCV均高于低分位组(P0.05),且随GluSD水平升高,NIHSS评分升高,MoCA评分及Barthl指数降低(P0.05)。Logistic回归分析发现,年龄、HbA_1c、GluAve、GluCV及NIHSS评分是糖尿病合并急性期脑卒中预后的危险因素(P0.05或P0.01)。结论糖尿病合并急性期脑卒中患者血糖变异性与不良预后相关,提示减少血糖波动可能更有利于改善预后。因此,在降低血糖水平的同时,需有效控制血糖波动。
[Abstract]:Objective: To investigate the correlation between acute stage stroke patients blood glucose variability and short-term prognosis of diabetic patients with diabetes mellitus. Methods 155 cases of patients with acute stroke, according to the standard deviation of blood glucose (GluSD) group divided into glucose variability (GluSD = 1.4mmol/L) and 92 cases of non blood glucose variation group (GluSD1.4mmol/L) according to the 63 cases. The level of GluSD group was three glucose variability subgroups, from low to high were low quartile (GluSD 1.42~1.87mmol/L) group (GluSD 1.43~2.32mmol/L) in a group and a high score (GluSD 2.33~2.87mmol/L) group. Each group after admission underwent 72h dynamic monitoring of blood glucose (CGM), the calculation of CGM index, the United States to stroke the National Institutes of Health (NIHSS) score, Montreal cognitive assessment scale (MoCA) and Barthel index to evaluate the prognosis of the situation in the short term. By Logistic regression analysis in patients with acute stroke poor short-term prognosis of diabetic patients with The factors affecting the variation of blood glucose. The results of group FPG[(8.49 + 1.71) vs (7.33 + 1.58) mmol/L], HbA_1c[(8.61 + 0.55)%vs (7.14 + 0.43) detected GluAve, GluMAGE, GluGLI and GluCV were higher than those of the variation of blood glucose group (P0.05 or P0.01); high score in group GluAve, GluMAGE, GluGLI and GluCV were higher than the low score group (P0.05), and with the increase of GluSD levels, elevated NIHSS score, MoCA score and Barthl index decreased (P0.05).Logistic regression analysis showed that age, HbA_1c, GluAve, GluCV and NIHSS score were risk factors of prognosis in patients with acute stroke combined with diabetes (P0.05 or P0.01). Conclusion diabetes complicated with acute during the period of blood glucose variability in patients with stroke associated with poor prognosis, suggesting reduced blood glucose fluctuation may be more conducive to improve the prognosis. Therefore, in reducing the blood glucose level at the same time, the need for effective control of blood glucose fluctuation.

【作者单位】：郑州人民医院内分泌科;
【分类号】：R587.1;R743.33

【参考文献】