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目的研究外伤性弥漫性轴索损伤患者高血糖与预后的关系。方法前瞻性对 118例中、重型外伤性弥漫性轴索损伤患者进行研究, 监测入院时、入院后 3 d、7 d 和两周时的神经元特异性烯醇化酶(NSE)、血糖、GCS, 于出院时和三个月后作 GOS 预后评分, 分析血糖水平与损伤严重度和神经功能预后的关系。结果死亡患者入院时血糖水平显著高于存活患者 (260mg/dLvs 130 mg/dL,P<0.005)。入院时血糖≥260 mg/dL 的患者均死亡。结论弥漫性轴索损伤常发生应激反应性早期高血糖, 它是损伤严重度的指示剂和可靠的预后预测指标。
Objective To study the relationship between hyperglycemia and prognosis in traumatic diffuse axonal injury. Methods A total of 118 patients with severe traumatic diffuse axonal injury were prospectively studied. Neuron-specific enolase (NSE), blood glucose, GCS , GOS prognostic score at discharge and three months later, the relationship between the level of blood glucose and the severity of injury and the prognosis of neurological function. Results At death, the blood glucose level was significantly higher in survivors than in survivors (260 mg / dL vs 130 mg / dL, P <0.005). All patients died of glucose ≥260 mg / dL on admission. Conclusions Diffuse axonal injury often leads to stress-responsive early hyperglycemia, which is an indicator of severity of injury and a reliable predictor of prognosis.