CAJ | 학술논문

目的研究外伤性弥漫性轴索损伤患者高血糖与预后的关系.方法前瞻性对118例中、重型外伤性弥漫性轴索损伤患者进行研究,监测入院时、入院后3 d、7 d和两周时的神经元特异性烯醇化酶(NSE)、血糖、GCS,于出院时和三个月后作GOS预后评分,分析血糖水平与损伤严重度和神经功能预后的关系.结果死亡患者入院时血糖水平显著高于存活患者(260mg/dLvs130mg/dL,P＜0.005).入院时血糖≥260 mg/dL的患者均死亡.结论弥漫性轴索损伤常发生应激反应性早期高血糖,它是损伤严重度的指示剂和可靠的预后预测指标.
목적연구외상성미만성축색손상환자고혈당여예후적관계.방법전첨성대118례중、중형외상성미만성축색손상환자진행연구,감측입원시、입원후3 d、7 d화량주시적신경원특이성희순화매(NSE)、혈당、GCS,우출원시화삼개월후작GOS예후평분,분석혈당수평여손상엄중도화신경공능예후적관계.결과사망환자입원시혈당수평현저고우존활환자(260mg/dLvs130mg/dL,P＜0.005).입원시혈당≥260 mg/dL적환자균사망.결론미만성축색손상상발생응격반응성조기고혈당,타시손상엄중도적지시제화가고적예후예측지표.
Objective This study aimed to better examine the relationship between hyperglycemia and outcome after traumatic diffuse axonal injury (TDAI). Methods We prospectively studied 118patients with moderate or severe TDAI [Glasgow Coma Scale scores (GCS), 3～12] who were treated conservatively in the surgical intensive care unit of zhuhai hospital between January 2000 and December 2004. Serum glucose, GCS and Glasgow Outcome Scale (GOS) of all the patients were measured: serum glucose, GCS score was recorded on admission, on days 3, 7 and 2 weeks; Outcome was determined by GOS score at discharge and after 3 months , respectively and the data were analyzed statistically to determine the relationship between serum glucose levels, severity of injury, and neurological outcome.Results Patients who died had significantly higher admission serum glucose values than those patients who survived (230 mg/dL vs 130 mg/dL, P＜0.005). Admission serum glucose ≥210 mg/dL was uniformly associated with a worse outcome. Conclusion Early hyperglycemia is a significant indicator of its severity, and a reliable predictor of outcome to TDAI.