摘要
【目的】分析糖代谢异常合并急性脑梗死的病变特点，探讨糖代谢异常对患者早期预后的影响。【方法】连续纳入本院急性脑梗死病例307例，根据血糖化验结果分为两组：糖代谢异常组（糖尿病、糖调节受损）122例、正常血糖组185例。所有患者均完善头磁共振及血管超声等相关检查，并进行CISS分型。入院及发病2周采用美国国立卫生研究院卒中量表（NIHSS）进行评分，将评分的差值作为结局变量，分为预后良好（NIHSS差值≥4分或≥50％）及预后不良（NIHSS差值＜4分＜50％）组，比较各组相关情况。【结果】①糖代谢异常组大动脉粥样硬化（LAA）及心源性卒中（CS）的比例高于正常血糖组，且两组相比较差异具有显著性（ P＜0．05）。两组穿支动脉疾病（PAD）发生率相比较差异无显著性（ P＞0．05）。②糖代谢异常组再发性、大面积梗死发生率明显高于正常血糖组，且两组相比较差异具有显著性（ P＜0．05）。③正常血糖组早期预后良好者为64．86％（120/185），明显高于糖代谢异常组45．90％（56/122），且两组相比较差异有显著性（χ2＝6．05，P ＜0．05）。【结论】糖代谢异常可加快大动脉硬化进程，为急性脑梗死早期预后差的独立危险因素。
[Objective] To analyze the characteristics of abnormal glucose metabolism with acute cerebral infarction , and to explore the impact of abnormal glucose metabolism on early prognosis of patients .[Methods]Totally 307 patients with acute cerebral infarction consecutively recruited in our hospital were chosen .According to glucose chemical examina-tion results ,all patients were divided into abnormal glucose metabolism group （diabetes and impaired glucose regulation ,n=122） and normal glucose group（ n=185） .Cerebral magnetic resonance image and vascular ultrasound were performed in all patients .The patients were classified by CISS .National institutes of health stroke scale （NIHSS） on admission and 2 weeks after stroke onset was used for scoring .According to the difference of scores as outcome variables ,the patients were divided into good prognosis group（NIHSS difference≥4 or ≥50% ） and poor prognosis group（NIHSS difference〈4 or 〈50% ） .The related condition of each group was compared .[Results] The percentage of large artery atherosclerosis （LAA） and cardiac stroke（CS） in abnormal glucose metabolism group was higher than that in normal glucose group ,and there was significant difference （ P〈0 .05） .There was no significant difference in the incidence of perforating branch ar-tery disease（PAD） between two groups（ P〉0 .05） .The incidence of recurrent and large infarction in abnormal glucose metabolism group was obviously higher than that in normal glucose group ,and there was significant difference （ P 〈0 .05） .The percentage of good early prognosis in normal glucose group was 64 .86% （120/185） ,which was obviously higher than that in abnormal glucose group （45 .90% ,56/122） ,and there was significant difference （χ2 = 6 .05 ,P 〈0 .05） .[Conclusion] Abnormal glucose metabolism can accelerate the process of LAA ,and is the independent risk factor of poor early prognosis of acute cerebral infarction .
出处
《医学临床研究》
CAS
2014年第2期239-240,243,共3页
Journal of Clinical Research
基金
沈阳市科学技术项目（F12-193-9-34）
关键词
脑梗死
葡萄糖代谢障碍
预后
Brain Infarction
Glucose Metabolism Disorders
Prognosis
