中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
1期
17-20
,共4页
梗塞,大脑中动脉,急性%高血糖症%胰岛素
梗塞,大腦中動脈,急性%高血糖癥%胰島素
경새,대뇌중동맥,급성%고혈당증%이도소
Infarction,middle cerebral artery%Hyperglycemia%Insulin
目的 探讨胰岛素强化治疗脑梗死伴高血糖的疗效及预后.方法 将70例伴有高血糖的脑梗死患者按随机数字表法分为两组,对照组35例,予以常规胰岛素治疗,将血糖控制在＜11.1 mmol/L;强化组35例,予以胰岛素泵强化治疗,将血糖控制在4.4～8.3 mmol/L.采用美国国立卫生院卒中量表(NIHSS)评分和改良Rankin量表(mRS)评分比较两组治疗前后神经功能缺损程度变化及日常生活改善情况.记录两组胰岛素用量及血糖达标并控制稳定所需时间、低血糖发生率,以及肺部感染率、病死率等.结果 两组治疗前NIHSS、mRS评分比较差异无统计学意义(P＞0.05).治疗30 d后,对照组NIHSS、mRS评分分别为(8.29±2.74)、(2.96±0.74)分,强化组分别为(6.83±3.16)、(2.02±0.62)分,均较治疗前明显改善,且强化组改善情况优于对照组,差异有统计学意义(P＜0.05).强化组每日胰岛素用量、血糖达标并控制稳定所需时间明显少于对照组[(36.40±6.91) U/d比(51.70±9.86) U/d、(4.30±0.87)d比(6.60±1.24)d],低血糖发生率及病死率明显低于对照组[5.7％ (2/35)比25.7％(9/35)、0比8.6％(3/35)],差异均有统计学意义(P＜0.05);而两组肺部感染发生率比较差异无统计学意义(P＞0.05).结论 胰岛素强化治疗脑梗死伴高血糖的疗效更好,并有利于神经功能的恢复.
目的 探討胰島素彊化治療腦梗死伴高血糖的療效及預後.方法 將70例伴有高血糖的腦梗死患者按隨機數字錶法分為兩組,對照組35例,予以常規胰島素治療,將血糖控製在＜11.1 mmol/L;彊化組35例,予以胰島素泵彊化治療,將血糖控製在4.4～8.3 mmol/L.採用美國國立衛生院卒中量錶(NIHSS)評分和改良Rankin量錶(mRS)評分比較兩組治療前後神經功能缺損程度變化及日常生活改善情況.記錄兩組胰島素用量及血糖達標併控製穩定所需時間、低血糖髮生率,以及肺部感染率、病死率等.結果 兩組治療前NIHSS、mRS評分比較差異無統計學意義(P＞0.05).治療30 d後,對照組NIHSS、mRS評分分彆為(8.29±2.74)、(2.96±0.74)分,彊化組分彆為(6.83±3.16)、(2.02±0.62)分,均較治療前明顯改善,且彊化組改善情況優于對照組,差異有統計學意義(P＜0.05).彊化組每日胰島素用量、血糖達標併控製穩定所需時間明顯少于對照組[(36.40±6.91) U/d比(51.70±9.86) U/d、(4.30±0.87)d比(6.60±1.24)d],低血糖髮生率及病死率明顯低于對照組[5.7％ (2/35)比25.7％(9/35)、0比8.6％(3/35)],差異均有統計學意義(P＜0.05);而兩組肺部感染髮生率比較差異無統計學意義(P＞0.05).結論 胰島素彊化治療腦梗死伴高血糖的療效更好,併有利于神經功能的恢複.
목적 탐토이도소강화치료뇌경사반고혈당적료효급예후.방법 장70례반유고혈당적뇌경사환자안수궤수자표법분위량조,대조조35례,여이상규이도소치료,장혈당공제재＜11.1 mmol/L;강화조35례,여이이도소빙강화치료,장혈당공제재4.4～8.3 mmol/L.채용미국국립위생원졸중량표(NIHSS)평분화개량Rankin량표(mRS)평분비교량조치료전후신경공능결손정도변화급일상생활개선정황.기록량조이도소용량급혈당체표병공제은정소수시간、저혈당발생솔,이급폐부감염솔、병사솔등.결과 량조치료전NIHSS、mRS평분비교차이무통계학의의(P＞0.05).치료30 d후,대조조NIHSS、mRS평분분별위(8.29±2.74)、(2.96±0.74)분,강화조분별위(6.83±3.16)、(2.02±0.62)분,균교치료전명현개선,차강화조개선정황우우대조조,차이유통계학의의(P＜0.05).강화조매일이도소용량、혈당체표병공제은정소수시간명현소우대조조[(36.40±6.91) U/d비(51.70±9.86) U/d、(4.30±0.87)d비(6.60±1.24)d],저혈당발생솔급병사솔명현저우대조조[5.7％ (2/35)비25.7％(9/35)、0비8.6％(3/35)],차이균유통계학의의(P＜0.05);이량조폐부감염발생솔비교차이무통계학의의(P＞0.05).결론 이도소강화치료뇌경사반고혈당적료효경호,병유리우신경공능적회복.
Objective To investigate the effect and prognosis of intensive insulin therapy on cerebral infarction combined with hyperglycemia.Methods Seventy cases of cerebral infarction combined with hyperglycemia were divided into two groups by random number table method.Thirty-five cases in control group,were treated with insulin,and the blood glucose was controlled ＜ 11.1 mmol/L; 35 cases in intensive group,were treated by insulin pump,and the blood glucose was controlled in 4.4-8.3 mmol/L.The degree of neurological damage and improvement of daily life in two groups before and after treatment was compared by National Institutes of Health Stroke Scale(NIHSS) and modified Rankin Scale(mRS) scores.Insulin dosage,the time for reaching the standard,incidence of hypoglycemia,pulmonary infection rate and fatality rate was recorded in two groups.Results The NIHSS and mRS scores between two groups before treatment had no statistical significance (P ＞ 0.05),and after 30 d treatment,the NIHSS and mRS scores in control group [(8.29 ±2.74),(2.96 ±0.74) scores] and intensive group [(6.83 ±3.16),(2.02 ±0.62) scores] were obviously improved compared with those before treatment,and the improvement in intensive group was better than that in control group (P＜ 0.05).In intensive group,the insulin dosage and the time for reaching the standard was less than that in control group [(36.40 ± 6.91) U/d vs.(51.70 ± 9.86) U/d,(4.30 ± 0.87)d vs.(6.60 ± 1.24) d],incidence of hypoglycemia and fatality rate was lower than that in control group[5.7％ (2/35) vs.25.7％ (9/35),0 vs.8.6％ (3/35)],the difference was statisticly significant (P ＜ 0.05),but the pulmonary infection rate between two groups had no statisticly difference (P ＞ 0.05).Conclusion The curative effect of intensive insulin therapy on cerebral infarction combined with hyperglycemia is better,and is helpful to the neural functional recovery.
