中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
34期
4-6
,共3页
脑梗塞%高血糖症%预后
腦梗塞%高血糖癥%預後
뇌경새%고혈당증%예후
Brain infarction%Hyperglycemia%Prognosis
目的 研究脑梗死后应激性高血糖的控制水平对神经功能恢复的影响.方法 将92例24 h内新发脑梗死伴高血糖患者按随机数字表法分为对照组和观察组,每组46例,对照组空腹血糖控制在4.0～6.0 mmol/L,观察组空腹血糖控制在6.1 ～ 8.3 mmol/L.比较两组低血糖发生率、感染率、病死率、神经功能评分(NIHSS评分)和日常生活能力评分(Barthel评分)情况.结果 治疗后,对照组基本痊愈、显著好转、好转及无效或恶化的患者分别为14、19、12、1例;观察组则分别为11、17、15、3例,两组疗效比较差异无统计学意义(P＞0.05).对照组低血糖发生率、感染率、病死率分别为19.6％(9/46)、10.9％(5/46)和2.2％(1/46);观察组分别为4.3％(2/46)、15.2％(7/46)和4.3％(2/46),两组低血糖发生率比较差异有统计学意义(P＜0.05),而感染率及病死率比较差异无统计学意义(P＞0.05).两组治疗前NIHSS评分和Barthel评分比较差异无统计学意义(P＞0.05),对照组治疗1周后、30 d后NIHSS评分和治疗30 d后Barthel评分分别为(15.47±7.78)、(9.85±6.47)、(67.18±20.24)分;观察组分别为(16.01±7.49)、(10.17±5.84)、(65.82±19.93)分,与治疗前比较均有明显改善,但两组间比较差异无统计学意义(P＞0.05).结论 脑梗死后应激性高血糖空腹血糖控制在6.1～8.3 mmol/L水平不增加感染率及病死率,不影响神经功能及日常生活能力恢复,但能有效降低低血糖的发生率.
目的 研究腦梗死後應激性高血糖的控製水平對神經功能恢複的影響.方法 將92例24 h內新髮腦梗死伴高血糖患者按隨機數字錶法分為對照組和觀察組,每組46例,對照組空腹血糖控製在4.0～6.0 mmol/L,觀察組空腹血糖控製在6.1 ～ 8.3 mmol/L.比較兩組低血糖髮生率、感染率、病死率、神經功能評分(NIHSS評分)和日常生活能力評分(Barthel評分)情況.結果 治療後,對照組基本痊愈、顯著好轉、好轉及無效或噁化的患者分彆為14、19、12、1例;觀察組則分彆為11、17、15、3例,兩組療效比較差異無統計學意義(P＞0.05).對照組低血糖髮生率、感染率、病死率分彆為19.6％(9/46)、10.9％(5/46)和2.2％(1/46);觀察組分彆為4.3％(2/46)、15.2％(7/46)和4.3％(2/46),兩組低血糖髮生率比較差異有統計學意義(P＜0.05),而感染率及病死率比較差異無統計學意義(P＞0.05).兩組治療前NIHSS評分和Barthel評分比較差異無統計學意義(P＞0.05),對照組治療1週後、30 d後NIHSS評分和治療30 d後Barthel評分分彆為(15.47±7.78)、(9.85±6.47)、(67.18±20.24)分;觀察組分彆為(16.01±7.49)、(10.17±5.84)、(65.82±19.93)分,與治療前比較均有明顯改善,但兩組間比較差異無統計學意義(P＞0.05).結論 腦梗死後應激性高血糖空腹血糖控製在6.1～8.3 mmol/L水平不增加感染率及病死率,不影響神經功能及日常生活能力恢複,但能有效降低低血糖的髮生率.
목적 연구뇌경사후응격성고혈당적공제수평대신경공능회복적영향.방법 장92례24 h내신발뇌경사반고혈당환자안수궤수자표법분위대조조화관찰조,매조46례,대조조공복혈당공제재4.0～6.0 mmol/L,관찰조공복혈당공제재6.1 ～ 8.3 mmol/L.비교량조저혈당발생솔、감염솔、병사솔、신경공능평분(NIHSS평분)화일상생활능력평분(Barthel평분)정황.결과 치료후,대조조기본전유、현저호전、호전급무효혹악화적환자분별위14、19、12、1례;관찰조칙분별위11、17、15、3례,량조료효비교차이무통계학의의(P＞0.05).대조조저혈당발생솔、감염솔、병사솔분별위19.6％(9/46)、10.9％(5/46)화2.2％(1/46);관찰조분별위4.3％(2/46)、15.2％(7/46)화4.3％(2/46),량조저혈당발생솔비교차이유통계학의의(P＜0.05),이감염솔급병사솔비교차이무통계학의의(P＞0.05).량조치료전NIHSS평분화Barthel평분비교차이무통계학의의(P＞0.05),대조조치료1주후、30 d후NIHSS평분화치료30 d후Barthel평분분별위(15.47±7.78)、(9.85±6.47)、(67.18±20.24)분;관찰조분별위(16.01±7.49)、(10.17±5.84)、(65.82±19.93)분,여치료전비교균유명현개선,단량조간비교차이무통계학의의(P＞0.05).결론 뇌경사후응격성고혈당공복혈당공제재6.1～8.3 mmol/L수평불증가감염솔급병사솔,불영향신경공능급일상생활능력회복,단능유효강저저혈당적발생솔.
Objective To analyze the effect of blood glucose control level on prognosis in cerebral infarction with stress hyperglycemia.Methods Ninety-two cases of new cerebral infarction within 24 h with stress hyperglycemia were divided into control group (46 cases) and observation group (46 cases).The blood glucose was controlled in 4.0-6.0 mmol/L in control group and 6.1-8.3 mmol/L in observation group.The hypoglycemia rate,infection rate,fatality rate,NIHSS score and Barthel score was observed in two groups.Results In control group,there were 14 cases cured,19 cases significantly improved,12 cases improved and 1 case invalid,while in observation group,there were 11,17,15,3 cases respectively,and the difference was not statisticly significant (P ＞ 0.05).The hypoglycemia rate,infection rate,fatality rate was 19.6％(9/46),10.9％(5/46) and 2.2％(1/46) respectively in control group,while in observation group was 4.3％ (2/46),15.2％ (7/46) and 4.3％ (2/46) respectively.The hypoglycemia rate was different between two groups(P ＜ 0.05),but the infection rate and fatality rate was not statistic difference between two groups(P ＞0.05).The NIHSS and Barthel score was not different between two groups before treatment (P ＞ 0.05).In control group the NIHSS after 1 week and 30 days after treatment and Barthel score 30 days after treatment was (15.47 ± 7.78),(9.85 ± 6.47),(67.18 ± 20.24) scores respectively,in observed group was (16.01 ±7.49),(10.17 ±5.84),(65.82 ± 19.93) scores respectively,which was improved compared with that pretreatment,but there was no significant difference between two groups(P ＞ 0.05).Conclusion The blood glucose controlled in 6.1-8.3 mmol/L does not increase the infection rate and fatality rate,but can reduce the hypoglycemia rate and promote neural function recovery in cerebral infarction with stress hyperglycemia.
