高血糖对急性出血性卒中早期预后的影响被引量：2

Influence of hyperglycemia on the prognosis of patients with acute hemorrhagic stroke in early stage

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摘要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 influence of hyperglycemia on the prognosis of patients with acute hemorrhagic stroke in early stage. Methods In a consecutive way, 105 patients with acute hemorrhagic stroke （〈72 hours） were enrolled in this prospective study. The scores of National Institutes of Health Stroke Scale （NIHSS） were calculated and the random serum glucose concentrations when they were admitted to hospital were tested, and the scores of Modified Rankin Scales （mRS） were evaluated 30 days after stroke. The multivariate stepwise logistic regression analysis on the factors affecting the glycemia level and on the influence of hyperglycemia on the prognosis of patients were carried out. Results （1）Of the 105 patients, 61 （58. 1%） presented with hyperglycemia at admission. Age, history of diabetes mellitus, infection, and NIHSS score were risk factors for acute hemorrhagic stroke accompanied with hyperglycemia （P〈0. 05）. History of diabetes mellitus and NIHSS score were independent risk factors for acute hemorrhagic stroke patients accompanied with hyperglycemia （P〈 0. 05）. （2） The influence of infection, hyperglycemia, and NIHSS score on the score of mRS were statistically significant （P〈0.01）, and hyperglycemia and NIHSS score were independent risk factors for poor prognosis （P〈 0. 05）. Conclusion Hyperglycemia in the acute stage of hemorrhagic stroke predicates a serious degree of stroke. Hyperglycemia is an independent risk factor for poorer outcome in patients with acute hemorrhagic stroke in early stage.

作者李佐君钟历勇綦雯雯王春雪赵性泉

机构地区首都医科大学附属北京天坛医院内分泌科首都医科大学附属北京天坛医院神经内科

出处《中国糖尿病杂志》 CAS CSCD 北大核心 2012年第6期424-427,共4页 Chinese Journal of Diabetes

关键词高血糖卒中出血性预后 Hyperglycemia Stroke Hemorrhage Prognosis

分类号 R743.3 [医药卫生—神经病学与精神病学]

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