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目的探讨60例糖尿病并经CT证实脑梗死患者的血糖、胰岛素抵抗(IR)与其梗塞灶最大直径、神经功能损伤、临床疗效、并发症和病死率的关系。方法60例糖尿病并脑梗死与60例非糖尿病脑梗死进行比较,糖尿病并脑梗死60例中大灶梗死亚组与小灶梗死亚组比较,计算胰岛素敏感指数(ISI),并与神经功能缺失、梗死灶面积进行直线相关分析。结果糖尿病并脑梗死时多为主干支大灶性梗死,且神经功能损伤重,临床疗效差,并发症和病死率高。另外脑梗死面积、并发症和病死率均与血糖水平、ISI等呈正相关。结论血糖水平升高,胰岛素抵抗加重脑梗死损害,适当使用胰岛素降低血糖并减少胰岛素抵抗对脑梗死治疗及预后是有益的。
Objective To investigate the relationship between blood glucose, insulin resistance (IR) and the maximum diameter of infarction, neurological impairment, clinical efficacy, complications and mortality in 60 diabetic patients confirmed by CT. Methods 60 cases of diabetes mellitus and cerebral infarction compared with 60 cases of non-diabetic cerebral infarction, diabetes mellitus and cerebral infarction in 60 cases of large infarct subgroup and small infarct subgroup, insulin sensitivity index (ISI) was calculated, and with neurological deficit, infarction Stove area for linear correlation analysis. Results Diabetes mellitus and cerebral infarction were mostly main branch of large infarction, and severe neurological damage, poor clinical efficacy, complications and high mortality. In addition, infarct size, complications and mortality were positively correlated with blood glucose level, ISI and so on. CONCLUSIONS: Increased blood glucose level and insulin resistance aggravate cerebral infarction damage. Appropriate use of insulin to reduce blood glucose and reduce insulin resistance is beneficial to the treatment and prognosis of cerebral infarction.