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目的探讨高血糖在动脉硬化性脑梗死(ACI)患者急性期和恢复期中的作用和意义。方法用葡萄糖氧化酶法测定91例ACI患者急性期和恢复期的血糖浓度,按神经功能缺损程度标准于入院后1周内和3周后对患者进行神经功能缺损程度评分(NFV)。结果ACI患者急性和恢复期的血糖浓度显著高于健康对照组(P<0.01,P<0.05),急性期的血糖浓度又显著高于恢复期(P<0.05)。急性期和恢复期的脑梗死体积(CIV)为(8.75±1.21)和(6.34±4.14)cm3,NFV为(18.56±3.62)和(7.54±5.82),恢复期与急性期比较,两项参数均显著减小(P<0.05,P<0.01)。ACI患者急性期的血糖浓度与急性期和恢复期的CIV和NFV显著正相关(r=0.60,P<0.01;r=0.58,P<0.01;r=0.56,P<0.01;r=0.52,P<0.01),恢复期的血糖浓度与CIV和NFV不相关(r=0.09,P>0.05;r=0.08,P>0.05)。结论ACI患者急性期的高血糖加重缺血性脑损伤,提示临床预后不良;恢复期的高血糖在脑动脉粥样硬化中发挥重要的作用。
Objective To investigate the role and significance of hyperglycemia in acute and convalescent patients with arteriosclerotic cerebral infarction (ACI). Methods Glucose oxidase method was used to determine the blood glucose levels in acute and convalescent phase in 91 patients with ACI. Neurological deficit score (NFV) was assessed within 1 week and 3 weeks after admission according to the degree of neurological deficit. Results The acute and convalescent blood glucose levels in ACI patients were significantly higher than those in healthy controls (P <0.01, P <0.05). The blood glucose levels in acute phase were significantly higher than those in convalescent patients (P <0.05). The volume of cerebral infarction (CIV) in acute phase and convalescent phase were (8.75 ± 1.21) and (6.34 ± 4.14) cm3, NFV was (18.56 ± 3.62) and (7.54 ± 5.82) respectively. Significantly decreased (P <0.05, P <0.01). The acute blood glucose levels in ACI patients were significantly and positively correlated with CIV and NFV in acute phase and convalescent phase (r = 0.60, P <0.01; r = 0.58, P <0.01; r = 0.56, <0.01). The blood glucose level in convalescence was not correlated with CIV and NFV (r = 0.09, P> 0.05; r = 0.08, P> 0.05). Conclusions Hyperglycemia in acute ACI patients aggravates ischemic brain injury, suggesting poor prognosis. Hyperglycemia in convalescent stage plays an important role in cerebral atherosclerosis.