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为了进一步探讨血糖与卒中的关系,指导临床治疗,下面对近年来国外有关血糖与卒中的新观点复习如下。一、低血糖与卒中低血糖能否引起卒中?答案是不能直接引起。但低血糖确实和卒中样症状有关。在病理表现上,低血糖性脑损伤以及由此而致的机理不明的短暂性偏瘫、失语,与脑缺血时所见不同。当脑组织持续性的病理改变是由低血糖所致时,则在脑皮层表面,侧脑室附近,海马回尤其是齿状回呈现选择性的多神经原损伤(如皮质深层中部的第3,5,6层锥体细胞以及海马回CA_1区锥体细胞)。缺血性脑梗塞时除了引起神经原死亡外,胶质细胞、内皮细胞也死亡。低血糖破坏树突,但它不象脑缺血,它不损伤轴突。在代谢方面,低血糖期间脑内乳酸不会升高,组织的pH不会下降。同样ATP能量的下降就没有脑缺血时那样有意义,因为低血糖时动用了其他非糖元燃料,所以血液供
In order to further explore the relationship between blood glucose and stroke and guide clinical treatment, the following new reviews on blood sugar and stroke in foreign countries are reviewed below. First, hypoglycemia and stroke hypoglycemia can cause stroke? The answer is not directly caused. However, hypoglycemia is indeed associated with stroke-like symptoms. Pathologically, hypoglycemic brain injury and the resulting transient hemiparesis with unknown mechanisms, aphasia, and cerebral ischemia are seen. When the persistent pathological changes in brain tissue are caused by hypoglycaemia, selective polyneuronal lesions appear on the surface of the cortex, near the lateral ventricle, and the hippocampus, especially the dentate gyrus (such as the third, 5,6 pyramidal cells and hippocampal CA1 pyramidal cells). In addition to ischemic cerebral infarction caused by neuronal death, glial cells, endothelial cells also died. Hypoglycemia destroys the dendrites, but unlike cerebral ischemia, it does not damage the axons. In metabolism, the brain lactic acid does not rise during hypoglycemia, tissue pH will not decline. Similarly, the decrease in ATP energy is less relevant than cerebral ischemia, because other non-glycemic fuels are used in hypoglycemia, so the blood supply