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探讨中老年急性脑血管病早期高血糖调治范围及调治方法。方法:年龄40-80岁,发病在48小时之内的急性脑血管病3544例病人被随机分人治疗组和对照组。每组1772例。治疗组依据急性脑血管病早期高血糖调治技术,应激性高血糖恒定在7.00-7.50mmol/L,糖尿病性高血糖稳定在MBGC+1.50-2.00mmol/L.采用8点法和5点法监测血糖,指导胰岛素用量。对照组采用常规治疗方法。观察临床疗效和预后状况。结果:发病后第10、30天,CSS临床疗效评分,治疗组在基本治愈、显效、好转及总有效方面均明显高于对照组(P<0.01),而在无效或恶化以及死亡方面明显低于对照组(P<0.01)。对照组极易发生低血糖,缺血灶扩大,肢体瘫痪加重及混合性卒中,且预后较治疗组差(P<0.01)。结论:中老年急性脑血管病后应激性高血糖者血糖调治在7.00-7.50mmol/L,糖尿病性在MBGC+1.50-2.00mmol/L,可以获得更好的临床疗效。8点法和5点法可以很好地监测血糖水平,指导胰岛素应用。
To explore the early stage of acute cerebrovascular disease in the treatment of high blood sugar and treatment methods. Methods: A total of 3544 patients with acute cerebrovascular disease aged 40-80 years and with onset within 48 hours were randomly assigned to treatment group and control group. 1772 cases in each group. The treatment group according to the early treatment of acute cerebrovascular disease hyperglycemia, stress hyperglycemia constant at 7.00-7.50mmol / L, diabetic hyperglycemia stabilized at MBGC 1.50-2.00mmol / L. 8:00 and 5:00 method Monitor blood glucose, guide the amount of insulin. Control group using conventional treatment. To observe the clinical efficacy and prognosis. Results: On the 10th and 30th day after onset, the CSS clinical efficacy score was significantly higher in the treatment group than in the control group (P <0.01), but significantly lower in ineffective or worsening and death In the control group (P <0.01). Control group were prone to hypoglycemia, ischemic enlargement, limb paralysis and mixed stroke, and the prognosis was worse than the treatment group (P <0.01). Conclusion: The blood glucose of stress hyperglycemia in middle-aged and elderly patients with acute hyperglycemia is in the range of 7.00-7.50mmol / L, and the diabetes mellitus is in MBGC + 1.50-2.00mmol / L, so that better clinical curative effect can be obtained. The 8-point and 5-point methods monitor glucose levels well and guide insulin use.