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目的 :探讨急性脑梗死时血糖升高的原因及其对神经功能的影响。方法 :前瞻性分析 180例急性脑梗死患者空腹血糖(FBG)、胰岛素 (Ins)、胰岛素敏感指数的变化 (ISI) ,并分析其与脑梗死神经功能缺损和恢复的相关性。结果 :脑梗死急性期出现血糖水平升高者共 12 1例 ,85例为已确诊的糖尿病患者 ,11例为漏诊的糖尿病和糖耐量减低者 ,2 5例为一过性血糖升高的非糖尿病患者 ;一过性高血糖组恢复期的血糖水平较急性期明显下降 ,胰岛素水平则上升 ;糖尿病组急性期的胰岛素水平明显高于一过性高血糖组和血糖正常组 ;一过性高血糖组急性期的神经功能缺损较血糖正常组、糖尿病组严重 ,且其急性期血糖水平与其神经功能缺损评分呈正相关 ;结论 :急性脑梗死时血糖升高在非糖尿病患者和应激有关 ,其血糖升高程度与病变严重性相关。
Objective: To investigate the causes of hyperglycemia in acute cerebral infarction and its effect on neurological function. Methods: The changes of fasting blood glucose (FBG), insulin (Insulin) and insulin sensitivity index (ISI) in 180 patients with acute cerebral infarction were prospectively analyzed. The correlation between ISI and neurological deficits and recovery after cerebral infarction was analyzed. Results: In the acute phase of cerebral infarction, there were 121 cases of elevated blood glucose levels, 85 cases were diagnosed with diabetes, 11 cases were missed diagnosis of diabetes mellitus and impaired glucose tolerance, 25 cases of transient elevated blood sugar Diabetic patients; transient hyperglycemic group during the recovery of blood glucose levels were significantly lower than the acute phase, the insulin level is increased; diabetic acute phase insulin levels were significantly higher than the transient hyperglycemia and glycemic control group; transiently high In the acute phase, the neurological deficit in the blood glucose group was more serious than in the normal blood glucose group and the diabetic group, and there was a positive correlation between the blood glucose level and the neurological deficit score in the acute phase. CONCLUSION: The elevated blood glucose in the acute cerebral infarction is related to stress in non-diabetic patients. The degree of hyperglycemia is associated with the severity of the disease.