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目的观察住院期间高血糖对缺血性脑血管病患者预后的预测价值。方法选取无糖尿病病史且以首发缺血性脑血管病入院的患者150例为观察对象,分别测定入院随机血糖,≥7.8mmol/L定义为入院高血糖;第1、2、3、5、7天晨起空腹血糖,其平均值≥6.1mmol/L定义为住院期高血糖。以3个月死亡率作为评价指标。结果校正多个变量因素后,住院后发生高血糖与死亡风险增加相关(HR:1.80,95%CI:1.39～2.86,P<0.01),不论是入院时高血糖组的患者(HR:4.83,95%CI:1.93～12.06,P<0.01),还是入院时血糖正常组的患者(HR:1.64,95%CI:1.06～2.54,P=0.03)。住院后血糖达标的患者与持续性高血糖患者相比,死亡风险降低(HR:0.21,95%CI:0.08～0.52)。入院第一天血糖正常而后出现高血糖的患者与血糖持续正常的患者相比,死亡风险增加(HR:1.55,95%CI:1.01～2.39,P=0.04)。结论住院期间的高血糖与死亡率增加有关,对缺血性脑血管病的预后有预测价值。入院后血糖达标可提高生存率。
Objective To observe the predictive value of hyperglycemia in patients with ischemic cerebrovascular disease during hospitalization. Methods A total of 150 patients with no history of diabetes mellitus and admitted to hospital with first ischemic cerebrovascular disease were enrolled in this study. Randomized admission blood glucose was measured and ≥7.8mmol / L was defined as admission hyperglycemia. Fasting blood glucose from the morning, the average of ≥ 6.1mmol / L is defined as high blood sugar during hospitalization. The 3-month mortality rate was used as the evaluation index. Results After adjusting for multiple variables, hyperglycemia was associated with an increased risk of death after hospitalization (HR: 1.80, 95% CI: 1.39-2.86, P <0.01) 95% CI: 1.93-12.06, P <0.01), and patients with normal blood glucose level on admission (HR: 1.64, 95% CI: 1.06-2.54, P = 0.03). Patients who achieved glycemic control after hospital stay had a lower risk of death than those with persistent hyperglycemia (HR: 0.21, 95% CI: 0.08-0.52). Patients on the first day of admission who had normal glucose levels and then developed hyperglycemia had an increased risk of dying (HR 1.55, 95% CI 1.01 to 2.39, P 0.04) compared with those with sustained glycemia. Conclusions Hyperglycemia during hospitalization is associated with an increased mortality rate, which has predictive value for the prognosis of ischemic cerebrovascular disease. Blood glucose compliance after admission can improve the survival rate.