74例急性脑卒中合并糖代谢异常患者治疗及预后的前瞻性研究

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目的:探讨急性脑卒中患者血糖代谢异常的治疗方法及其对预后的影响。方法:抽取我院于2010年1月-2011年10月收治的74例急性脑卒中血糖代谢异常患者,按照入院时间先后将其分为对照组和实验组,其中对照组34例给予常规溶栓抗凝和抗血小板治疗,实验组40例行给予胰岛素联合溶栓抗凝和抗血小板综合治疗。对所有患者进行1-2个月的随访,对比两组患者的临床疗效和空腹血糖变化。结果:两组间治疗前相比,空腹血糖值差异无统计学意义(P>0.05);两组间治疗后相比,实验组患者的空腹血糖值(5.76±1.09)低于对照组(9.36±1.66),比较差异有统计学意义(P<0.05)。两组间相比,实验组患者的总有效率为97.5%,高于对照组的88.2%,统计学差异有意义(P<0.05)。实验组患者神经功能缺损评分(NDS)为39.4±2.4、格拉斯哥昏迷评分(GCS)为9.2±1.6和日常生活活动能力(ADL)为5.4±1.2均高于对照组(27.7±1.4、6.4±1.2、3.8±1.3),比较差异有统计学意义(P<0.05)。结论:运用诺和灵、血栓通、奥扎格雷联合治疗急性脑卒中合并血糖代谢异常,可有效地改善患者的血糖变化和脑部功能。 Objective: To investigate the treatment of acute cerebral apoplexy patients with abnormal glucose metabolism and its effect on prognosis. Methods: Totally 74 patients with abnormal blood glucose and glucose metabolism in our hospital from January 2010 to October 2011 were selected and divided into control group and experimental group according to the time of admission. The control group of 34 patients received conventional thrombolysis Anticoagulant and antiplatelet therapy, 40 cases of experimental group given insulin combined thrombolysis and antiplatelet therapy. All patients were followed up 1-2 months, compared the clinical efficacy and fasting blood glucose changes in both groups. Results: There was no significant difference in fasting blood glucose between the two groups before treatment (P> 0.05). Compared with the control group, the fasting blood glucose (5.76 ± 1.09) in the experimental group was lower than that in the control group ± 1.66), the difference was statistically significant (P <0.05). The total effective rate of the experimental group was 97.5%, which was higher than that of the control group (88.2%), the difference was statistically significant (P <0.05). The neurological deficit score (NDS) was 39.4 ± 2.4, the Glasgow Coma Scale (GCS) was 9.2 ± 1.6 and the activity of daily living (ADL) was 5.4 ± 1.2 in the experimental group was significantly higher than that of the control group (27.7 ± 1.4,6.4 ± 1.2 , 3.8 ± 1.3), the difference was statistically significant (P <0.05). CONCLUSION: The combination of noradrenaline, thrombus and ozagrel in the treatment of acute stroke complicated with abnormal glucose and glucose metabolism can effectively improve the blood glucose level and brain function in patients.
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