CAJ | 학술논문

目的：探讨糖化血红蛋白（ HbA1 c ）水平与糖尿病性急性脑梗死患者病情严重程度及预后的关系。方法收集2013年3月至11月在我院神经内科住院的合并糖尿病的急性脑梗死患者（发病72 h内）142例，所有患者均行头颅MRI检查明确诊断。根据入院后检测的HbA1c水平将患者分为3组。Ⅰ组：HbA1c＞9．0％；Ⅱ组：7．0％＜HbA1c≤9．0％；Ⅲ组：HbA1c≤7．0％。所有患者于入院后24 h内及出院3个月后采用美国国立卫生院卒中评分（ NIHSS）评定患者的病情严重程度，用Barthel 生活指数（ BI ）评定患者的日常生活能力，用改良的Rankin量表（ mRS）评定患者的病残程度。结果入院后3组患者的NIHSS评分结果比较，差异有统计学意义（ P＜0．05）。3个月后随访结果示3组NIHSS评分均较入院时明显下降，差异有统计学意义（P＜0．05）。Ⅰ组预后不良率为37．5％（18/48），Ⅱ组为31．4％（16/51），Ⅲ组为20．9％（9/43），3组之间比较差异有统计学意义（P＜0．05）。结论糖尿病性急性脑梗死患者的HbA1 c水平能反映病情严重程度及预后。
목적：탐토당화혈홍단백（ HbA1 c ）수평여당뇨병성급성뇌경사환자병정엄중정도급예후적관계。방법수집2013년3월지11월재아원신경내과주원적합병당뇨병적급성뇌경사환자（발병72 h내）142례，소유환자균행두로MRI검사명학진단。근거입원후검측적HbA1c수평장환자분위3조。Ⅰ조：HbA1c＞9．0％；Ⅱ조：7．0％＜HbA1c≤9．0％；Ⅲ조：HbA1c≤7．0％。소유환자우입원후24 h내급출원3개월후채용미국국립위생원졸중평분（ NIHSS）평정환자적병정엄중정도，용Barthel 생활지수（ BI ）평정환자적일상생활능력，용개량적Rankin량표（ mRS）평정환자적병잔정도。결과입원후3조환자적NIHSS평분결과비교，차이유통계학의의（ P＜0．05）。3개월후수방결과시3조NIHSS평분균교입원시명현하강，차이유통계학의의（P＜0．05）。Ⅰ조예후불량솔위37．5％（18/48），Ⅱ조위31．4％（16/51），Ⅲ조위20．9％（9/43），3조지간비교차이유통계학의의（P＜0．05）。결론당뇨병성급성뇌경사환자적HbA1 c수평능반영병정엄중정도급예후。
Objective To investigate the correlation between the levels of HbA 1c and the severity and prognosis of diabetic patients with acute cerebral infarction .Methods From March 2013 to November 2013 , 142 diabetic patients were admitted to our hospital within 72 hours after acute cerebral infarction and then diagnosed by cerebral MRI .The pa-tients were divided into three groups according to their levels of HbA 1c at admission: HbA1c>9.0% for Group Ⅰ;7.0%<HbA1c≤9.0%for Group Ⅱ;HbA1c≤7.0%for GroupⅢ.The severity of the patient's condition, their daily living abilities and disabilities were assessed using National Institute of Health stroke scale (NIHSS), the Barthel ADL index ( BI) and modified Rankin scale ( mRS) 24 hours respectively after admission and during follow -up visits three months after discharge .Results Significant differences were observed as to the NIHSS scores of three groups ( P<0.05).The scores were remarkably reduced three months after discharge (P<0.05).The percentage of poor prognosis was 37.5%(18/48) for group Ⅰ, 31.4%(16/51) for group Ⅱand 20.9%(9/43) for group Ⅲ, indicating statisti-cal differences (P<0.05).Conclusion The severity and prognosis of diabetic patients with acute cerebral infarction are positively related with the level of HbA 1c.