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目的观察磺酰脲类药物(SU)对2型糖尿病(T2DM)急性缺血性脑卒中出血性转换(HT)的影响。方法选取T2DM急性缺血性脑卒中患者240例,分为观察组80例(卒中前和卒中后连续使用SU)、对照组(卒中前及卒中后均未使用SU)160例,比较两组的基本特征、HT和死亡情况及出院时结局,P<0.05为差异有统计学意义。结果观察组男性患者比例较对照组多,入院时NIHSS≤9分所占比例高于对照组,入院前或住院当天应用抗血小板治疗者较对照组少。对照组20例(12.5%)发生sHT,观察组未发生sHT,差异有统计学意义(P<0.05);对照组死亡16例(10.0%),观察组无死亡,差异有统计学意义(P<0.05)。出院时表现为神经改善结局观察组16例,对照组4例,差异有统计学意义(P<0.05)。结论发病前后连续使用SU可抑制T2DM急性缺血性脑卒中HT,并改善患者临床预后。
Objective To observe the effects of sulfonylureas (SUs) on hemorrhagic conversion (HT) in type 2 diabetes mellitus (T2DM) patients with acute ischemic stroke. Methods A total of 240 T2DM patients with acute ischemic stroke were divided into observation group of 80 cases (pre-stroke and post-stroke continuous use of SU) and control group (pre-stroke and post-stroke without SU) in 160 cases, comparing the two groups The basic characteristics, HT and death and discharge at the outcome, P <0.05 for the difference was statistically significant. Results The proportion of male patients in the observation group was higher than that of the control group. The NIHSS ≤9 scores on admission were higher than those of the control group. There was less antiplatelet therapy before admission or hospitalization than the control group. In the control group, sHT occurred in 20 patients (12.5%), and no sHT occurred in the observation group (P <0.05). There were 16 deaths (10.0%) in the control group, and there was no death in the observation group <0.05). Discharged at the performance of neurological improvement in the observation group of 16 cases, 4 cases in the control group, the difference was statistically significant (P <0.05). Conclusions The continuous use of SU before and after onset can inhibit T2DM acute ischemic stroke HT and improve clinical prognosis.