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目的探讨高血糖对老年缺血性脑卒中患者急性期病情及临床疗效的影响。方法选取2013年2月—2014年2月丰城矿务局总医院收治的老年缺血性脑卒中患者264例,根据患者空腹血糖值分为高血糖组(空腹血糖>6.1 mmol/L)126例和正常血糖组(空腹血糖为3.9~6.1 mmol/L)138例。回顾性分析两组患者的临床资料,记录患者入院时和出院时神经功能缺损评分变化情况;颅脑CT检查患者梗死范围;判定患者临床疗效。结果高血糖组入院时神经功能缺损评分为(27.7±11.9)分、出院时为(15.1±10.7)分,分别高于正常血糖组的(18.5±10.3)分、(9.6±5.2)分(P<0.05);高血糖组局限梗死率为61.9%(78/126),低于正常血糖组的80.4%(111/138)(P<0.05);正常血糖组患者临床疗效优于高血糖组(P<0.05);直线相关分析结果显示,血糖水平与神经功能缺损评分呈正相关(r=7.562,P<0.05)。结论高血糖会对老年缺血性脑卒中患者急性期病情及临床疗效产生不利影响,血糖越高患者神经功能缺损程度越严重。
Objective To investigate the effect of hyperglycemia on the morbidity and clinical effect of acute ischemic stroke in elderly patients. Methods Two hundred and sixty-four elderly patients with ischemic stroke who were admitted to the General Hospital of Fengcheng Mining from February 2013 to February 2014 were selected and divided into hyperglycemia group (fasting blood glucose> 6.1 mmol / L) 126 Cases and normal blood glucose group (fasting blood glucose 3.9 ~ 6.1 mmol / L) in 138 cases. The clinical data of two groups of patients were retrospectively analyzed. The changes of neurological deficit scores on admission and discharge were recorded. The extent of infarction in patients underwent CT examination and the clinical efficacy were evaluated. Results The scores of neurological deficits in high glucose group were (27.7 ± 11.9) at admission and (15.1 ± 10.7) at discharge, respectively, which were significantly higher than those in normal blood glucose group (18.5 ± 10.3) and (9.6 ± 5.2) <0.05). The rate of local infarction in hyperglycemia group was 61.9% (78/126), which was lower than 80.4% (111/138) in normal glucose group (P <0.05). The clinical curative effect in patients with normal blood glucose was better than that in hyperglycemia group P <0.05). The linear correlation analysis showed that there was a positive correlation between blood glucose and neurological deficit score (r = 7.562, P <0.05). Conclusion Hyperglycemia may have an adverse effect on the condition and clinical efficacy of acute ischemic stroke patients. The higher the blood glucose, the more severe the neurological deficits.