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目的探讨糖尿病对脑梗死后自发性出血转化的预后影响,为临床治疗和预后评估提供参考。方法回顾性分析我院住院治疗118例脑梗死后自发性出血转化患者,根据是否合并糖尿病将入选患者分为糖尿病组和非糖尿病组,再据入院后糖尿病组7d空腹血糖水平分为正常血糖组、高血糖组,通过查阅患者影像、临床资料,观察出血转化类型及出血转化前、出血转化后、治疗2周后NIHSS评分。结果糖尿病组出血转化血肿型(HI)发生率较非糖尿病组明显高,差异具有统计学意义(P<0.05);糖尿病组出血转化后、治疗2周后NIHSS评分明显高于非糖尿病组,差异具有统计学意义(P<0.05);正常血糖组治疗2周NIHSS评分较高血糖组明显降低,差异具有统计学意义(P<0.05)。结论糖尿病性脑梗死后出血转化的患者预后明显差于未合并糖尿病的患者,但血糖控制正常的预后相对较好,故在临床治疗中需注意对糖尿病的筛查和治疗。
Objective To investigate the effect of diabetes on the prognosis of spontaneous hemorrhage after cerebral infarction, and to provide a reference for clinical treatment and prognosis evaluation. Methods A retrospective analysis of 118 hospitalized patients with spontaneous hemorrhage and conversion after cerebral infarction in our hospital was divided into diabetic patients and non-diabetic patients according to whether the patients with diabetes mellitus were merged or not. According to the 7d fasting blood glucose levels of diabetic patients after admission, , Hyperglycemia group. The NIHSS scores were observed after 2 weeks of treatment by referring the image of the patient and the clinical data, and observing the types of hemorrhagic transformation and the hemorrhagic transformation before hemorrhagic transformation. Results The incidence of hemorrhagic transformation hematoma (HI) in diabetic group was significantly higher than that in non-diabetic group (P <0.05). NIHSS score was significantly higher in diabetic group 2 weeks after treatment than that in non-diabetic group (P <0.05). NIHSS score in normal blood glucose group was significantly lower than that in high blood glucose group at 2 weeks, the difference was statistically significant (P <0.05). Conclusion The prognosis of patients with hemorrhagic transformation after diabetic cerebral infarction is obviously worse than those without diabetes. However, the prognosis of patients with normal blood glucose control is relatively good. Therefore, it is necessary to pay attention to the screening and treatment of diabetes in clinical treatment.