摘要
目的对比脑出血(intracerebral hemorrhage,ICH)合并糖尿病与大于截断值(FBG>7.8 mmol/L)应激性高血糖入院时病情及近期预后。方法回顾性连续纳入2012-01—2016-12重庆三峡中心医院和重庆医科大学附属大学城医院住院的3 352例(≥18岁)ICH患者,排除原发性高血压和影响其预后的其他危险因素患者2 577例。对符合入选标准的169例患者,分为脑出血合并糖尿病组(intracerebral hemorrhage with diabetes mellitus,ICHDM组)53例和脑出血合并应激性高血糖组(intracerebral hemorrhage with stress hyperglycemia,ICHSHG组)116例。应用单因素和有序多分类Logistic回归分析,探讨2组入院时病情及近期预后。结果 ICHSHG组入院时神经功能缺损程度重(P<0.001),出血量大(P<0.05)。Logistic回归分析表明,ICHSHG会显著增加近期预后不良的风险(OR=7.07;95%CI 3.16~15.83;P<0.001)。结论大于截断值的应激性高血糖患者脑出血量大,神经功能损伤严重,近期预后差。
Objective To investigate the patient＇s conditions at admission and short term prognosis in intracerebral hemorrhage（ICH） patients with diabetes mellitus and stress hyperglycemia above cut off value （FBG〉7.8 mmol/L）. Methods A total 3352 （≥18 years old） consecutive patients with ICH admitted to Chongqing Three Gorges Central Hospital and University Town Hospital of Chongqing Medical University from January 1,2012 to December 31,2016 were recruited retrospectively.After eliminating 2577 patients that suffered from hypertension and affected their prognosis on account of other risk factors,169 patients met the criteria,which were divided into intracerebral hemorrhage with diabetes mellitus group （ICHDM group, n =53） and intracerebral hemorrhage with stress hyperglycemia group （ICHSHG group, n =116）.The single factors and ordered multi classification logistic regress was used to analyze the patient＇s conditions at admission and short term prognosis between the two group. Results Compared with ICHDM group,neurologic function damage degree were severer（ P 〈0.001）,the amount of bleeding was higher（ P 〈0.05）in ICHSHG group.ICHSHG group showed increased risks of short term prognosis（ OR =7.07;95% CI ：3.16 15.83; P 〈0.001）,after adjusting multiple logistic regression. Conclusion The patients of stress hyperglycemia above cut off value may have larger the volume of cerebral hemorrhage sever neurologic function damage degree and worse short term prognosis.
作者
王彦月
WANG Yanyue(University Town Hospital of Chongqing Medical University,Chongqing 401331,China)
出处
《中国实用神经疾病杂志》
2018年第14期1541-1546,共6页
Chinese Journal of Practical Nervous Diseases
关键词
脑出血
出血性脑卒中
糖尿病
应激性高血糖
神经功能损伤
Intracerebral hemorrhage；Hemorrhagic stroke；Diabetes mellitus；Stress hyperglycemia；Prognosis；Neurological impairment
