论文部分内容阅读
【目的】分析糖代谢异常合并急性脑梗死的病变特点，探讨糖代谢异常对患者早期预后的影响。【方法】连续纳入本院急性脑梗死病例307例，根据血糖化验结果分为两组：糖代谢异常组（糖尿病、糖调节受损）122例、正常血糖组185例。所有患者均完善头磁共振及血管超声等相关检查，并进行CISS分型。入院及发病2周采用美国国立卫生研究院卒中量表（NIHSS）进行评分，将评分的差值作为结局变量，分为预后良好（NIHSS差值≥4分或≥50％）及预后不良（NIHSS差值＜4分＜50％）组，比较各组相关情况。【结果】①糖代谢异常组大动脉粥样硬化（LAA）及心源性卒中（CS）的比例高于正常血糖组，且两组相比较差异具有显著性（ P＜0．05）。两组穿支动脉疾病（PAD）发生率相比较差异无显著性（ P＞0．05）。②糖代谢异常组再发性、大面积梗死发生率明显高于正常血糖组，且两组相比较差异具有显著性（ P＜0．05）。③正常血糖组早期预后良好者为64．86％（120/185），明显高于糖代谢异常组45．90％（56/122），且两组相比较差异有显著性（χ2＝6．05，P ＜0．05）。【结论】糖代谢异常可加快大动脉硬化进程，为急性脑梗死早期预后差的独立危险因素。“,”[Objective] To analyze the characteristics of abnormal glucose metabolism with acute cerebral infarction , and to explore the impact of abnormal glucose metabolism on early prognosis of patients .[Methods]Totally 307 patients with acute cerebral infarction consecutively recruited in our hospital were chosen .According to glucose chemical examina-tion results ,all patients were divided into abnormal glucose metabolism group (diabetes and impaired glucose regulation ,n=122) and normal glucose group( n=185) .Cerebral magnetic resonance image and vascular ultrasound were performed in all patients .The patients were classified by CISS .National institutes of health stroke scale (NIHSS) on admission and 2 weeks after stroke onset was used for scoring .According to the difference of scores as outcome variables ,the patients were divided into good prognosis group(NIHSS difference≥4 or ≥50% ) and poor prognosis group(NIHSS difference<4 or <50% ) .The related condition of each group was compared .[Results] The percentage of large artery atherosclerosis (LAA) and cardiac stroke(CS) in abnormal glucose metabolism group was higher than that in normal glucose group ,and there was significant difference ( P0 .05) .The incidence of recurrent and large infarction in abnormal glucose metabolism group was obviously higher than that in normal glucose group ,and there was significant difference ( P <0 .05) .The percentage of good early prognosis in normal glucose group was 64 .86% (120/185) ,which was obviously higher than that in abnormal glucose group (45 .90% ,56/122) ,and there was significant difference (χ2 = 6 .05 ,P <0 .05) .[Conclusion] Abnormal glucose metabolism can accelerate the process of LAA ,and is the independent risk factor of poor early prognosis of acute cerebral infarction .