CAJ | 학술논문

背景:白细胞和血糖升高是急性脑血管病发生时的一种应激性反应,常出现在急性脑血管病的早期临床阶段.目的:观察急性脑血管病早期的白细胞、血糖水平,并探讨其与近期预后的相关性.设计:以诊断为依据,以患者为观察对象的预后分析.单位:青田县人民医院.对象:选择2000-05/2002-05青田县人民医院住院的急性脑血管患者235例.其中脑出血患者90例,男52例,女38例,年龄(63.13±9.55)岁;脑梗死145例,男73例,女72例,年龄(71.22±8.00)岁.病程≤1个月.按白细胞数分为正常白细胞组167例及白细胞增高组68例;根据血糖水平分为正常血糖组146例与高血糖组89例;神经功能缺损评分(轻型0～15分、中型16～30分、重型31～45分).方法:所有患者入院后即刻行头颅CT检查,并于次日清晨空腹静脉采血,测定血白细胞和空腹血糖.采用x2检验.主要观察指标:①急性脑血管病患者的病变类型与年龄的关系.②急性脑血管病病变类型、病情、预后与白细胞及血糖的关系.结果:①年龄比较:脑梗死组明显高于脑出血组[(71.22±8.00,63.13±9.55)岁,t=6.90,P＜0.001].②病变类型的百分率比较:白细胞增高组中,脑出血明显高于脑梗死(66%,34%,x2=31.47,P＜0.005);高血糖组中,脑出血高于脑梗死(51%,49%,x2=9.12,P＜0.005).③重型百分率比较:白细胞增高组明显高于正常白细胞组(26%,6%,x2=21.12,P＜0.005);高血糖组明显高于正常血糖组(27%,5%,x2=21.70,P＜0.005).④死亡百分率比较:白细胞增高组明显高于正常白细胞组(31%,6%,x2=26.15,P＜0.005);高血糖组明显高于正常血糖组(26%,5%,x2=20.02,P＜0.005).结论:白细胞及血糖升高均损伤脑组织,可用其判断急性脑血管病患者的病情,估计预后并指导其治疗.
배경:백세포화혈당승고시급성뇌혈관병발생시적일충응격성반응,상출현재급성뇌혈관병적조기림상계단.목적:관찰급성뇌혈관병조기적백세포、혈당수평,병탐토기여근기예후적상관성.설계:이진단위의거,이환자위관찰대상적예후분석.단위:청전현인민의원.대상:선택2000-05/2002-05청전현인민의원주원적급성뇌혈관환자235례.기중뇌출혈환자90례,남52례,녀38례,년령(63.13±9.55)세;뇌경사145례,남73례,녀72례,년령(71.22±8.00)세.병정≤1개월.안백세포수분위정상백세포조167례급백세포증고조68례;근거혈당수평분위정상혈당조146례여고혈당조89례;신경공능결손평분(경형0～15분、중형16～30분、중형31～45분).방법:소유환자입원후즉각행두로CT검사,병우차일청신공복정맥채혈,측정혈백세포화공복혈당.채용x2검험.주요관찰지표:①급성뇌혈관병환자적병변류형여년령적관계.②급성뇌혈관병병변류형、병정、예후여백세포급혈당적관계.결과:①년령비교:뇌경사조명현고우뇌출혈조[(71.22±8.00,63.13±9.55)세,t=6.90,P＜0.001].②병변류형적백분솔비교:백세포증고조중,뇌출혈명현고우뇌경사(66%,34%,x2=31.47,P＜0.005);고혈당조중,뇌출혈고우뇌경사(51%,49%,x2=9.12,P＜0.005).③중형백분솔비교:백세포증고조명현고우정상백세포조(26%,6%,x2=21.12,P＜0.005);고혈당조명현고우정상혈당조(27%,5%,x2=21.70,P＜0.005).④사망백분솔비교:백세포증고조명현고우정상백세포조(31%,6%,x2=26.15,P＜0.005);고혈당조명현고우정상혈당조(26%,5%,x2=20.02,P＜0.005).결론:백세포급혈당승고균손상뇌조직,가용기판단급성뇌혈관병환자적병정,고계예후병지도기치료.
BACKGROUND: The increase of leukocyte and blood glucose levels is a kind of stress reaction when acute cerebrovascular disease occurs, it often occurs at the early clinical stage of acute cerebrovascular disease.OBJECTIVE: To observe the levels of leukocyte and blood glucose at the early stage of acute cerebrovascular disease, and investigate their correlation with recent prognosis.DESIGN: A prognostic analysis based on diagnosis taken patients as observational subjects.SETTING: Qingtian County People's Hospital.PARTICIPANTS: Totally 235 inpatients with acute cerebrovascular disease aged (63.13±9.55) years were selected from Qingtian County People's Hospital between May 2000 and May 2002, including 90 cases of cerebral hemorrhage (52 males and 38 females) aged (63.13±9.55) years and 145 cases of cerebral infarction (73 males and 72 females) aged (71.22±8.00) years. The disease course ≤ 1 month. According to the number of leukocytes, the patients were divided into normal leukocyte group (n=167) and increased leukocyte group (n=68). According to the level of blood glucose, they were divided into normal blood glucose group (n=146) and hyperglycemia group (n=89). The neurologic deficit score (NDS) of 0-15 points was taken as mild, 16-30 as moderate and 31-45as severe.METHODS: All the patients received cranial CT examination immediately after admission, and fasting venous blood samples were drawn on the next morning to detect the levels of leukocyte and fasting blood glucose. The x2 test was applied.MAIN OUTCOME MEASURES: ① Comparison of age: It was obviously higher in the cerebral infarction group than in the cerebral hemorrhage group [(71.22±8.00), (63.13±9.55) years, t=6.90, P ＜ 0.001]. ② Comparison of the percentage of disease types: In the increased leukocyte group,the percentage of cerebral hemorrhage was obviously higher than that of cerebral infarction (66%, 34%, x2=31.47, P ＜ 0.005). In the hyperglycemia group, the percentage of cerebral hemorrhage was higher than that of cerebral infarction (51%, 49%, x2=9.12, P ＜ 0.005). ③ Comparison of the percentage of severe neurological impairment: It was obviously higher in the increased leukocyte group than in the normal leukocyte group (26%, 6%,x2=21.12, P ＜ 0.005), also markedly higher in the hyperglycemia group than in the normal blood glucose group (27%, 5%, x2=21.70, P ＜ 0.005).④ Comparison of the percentage of death: It was obviously higher in the increased leukocyte group than in the normal leukocyte group (31%, 6%,x2=26.15, P ＜ 0.005), also markedly higher in the hyperglycemia group than in the normal blood glucose group (26%, 5%, x2=20.02, P ＜ 0.005). CONCLUSION: Both the increase of leukocyte and blood glucose can damage the brain tissue, and can be used to judge the disease condition of patients with acute cerebrovascular disease, estimate the prognosis and guide the treatment.