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目的探讨高血糖对急性出血性卒中早期预后的影响。方法连续纳入发病72h内入院的急性出血性卒中患者105例,入院时评定美国国立卫生研究院卒中量表(NIHSS)评分并检测随机静脉血清葡萄糖,发病30d时进行改良Rankin量表评分(mRS)。采用多元逐步Logistic回归分析影响急性出血性卒中患者血糖水平的因素及高血糖对急性出血性卒中早期预后的影响。结果 (1)入选的105例急性出血性卒中患者中,61例(58.1%)出现高血糖,年龄、糖尿病史、感染、NIHSS评分是急性出血性卒中合并高血糖的危险因素(P<0.05),糖尿病史、NIHSS评分是急性出血性卒中合并高血糖的独立危险因素(P<0.05)。(2)感染、高血糖、NIHSS评分对mRS评分的影响有统计学差异(P<0.01),高血糖、NIHSS评分是急性出血性卒中预后不良的独立危险因素(P<0.05)。结论急性出血性卒中合并高血糖是反映急性出血性卒中病情较重的指标之一,高血糖是急性出血性卒中早期预后不良的独立危险因素。
Objective To investigate the effect of hyperglycemia on the early prognosis of acute hemorrhagic stroke. Methods A total of 105 patients with acute hemorrhagic stroke who were hospitalized within 72 hours after onset were enrolled in the study. NIHSS score and randomized venous serum glucose were assessed at admission. Modified Rankin Scale (mRS) . Multivariate stepwise logistic regression analysis was used to analyze the factors influencing the blood glucose level in patients with acute hemorrhagic stroke and the effect of hyperglycemia on the early prognosis of acute hemorrhagic stroke. Results (1) Among the 105 patients with acute hemorrhagic stroke, the incidence of hyperglycemia, age, history of diabetes, infection and NIHSS score were the risk factors of acute hemorrhagic stroke with hyperglycemia in 61 (58.1%) patients (P <0.05) , History of diabetes mellitus, NIHSS score was an independent risk factor for acute hemorrhagic stroke with hyperglycemia (P <0.05). (2) The infection, hyperglycemia and NIHSS scores had statistical significance (P <0.01). Hyperglycemia and NIHSS score were independent risk factors for acute hemorrhagic stroke with poor prognosis (P <0.05). Conclusions Acute hemorrhagic stroke with hyperglycemia is one of the indicators of severe hemorrhagic stroke. Hyperglycemia is an independent risk factor for early prognosis of acute hemorrhagic stroke.