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背景:白细胞和血糖升高是急性脑血管病发生时的一种应激性反应,常出现在急性脑血管病的早期临床阶段。目的:观察急性脑血管病早期的白细胞、血糖水平,并探讨其与近期预后的相关性。设计:以诊断为依据,以患者为观察对象的预后分析。单位:青田县人民医院。对象:选择2000-05/2002-05青田县人民医院住院的急性脑血管患者235例。其中脑出血患者90例,男52例,女38例,年龄穴63.13±9.55雪岁;脑梗死145例,男73例,女72例,年龄穴71.22±8.00雪岁。病程≤1个月。按白细胞数分为正常白细胞组167例及白细胞增高组68例;根据血糖水平分为正常血糖组146例与高血糖组89例;神经功能缺损评分穴轻型0～15分、中型16～30分、重型31～45分雪。方法:所有患者入院后即刻行头颅CT检查,并于次日清晨空腹静脉采血,测定血白细胞和空腹血糖。采用χ2检验。主要观察指标:①急性脑血管病患者的病变类型与年龄的关系。②急性脑血管病病变类型、病情、预后与白细胞及血糖的关系。结果:①年龄比较:脑梗死组明显高于脑出血组眼(71.22±8.00,63.13±9.55)岁,t=6.90,P<0.001演。②病变类型的百分率比较:白细胞增高组中,脑出血明显高于脑梗死(66%,34%,χ2=31.47,P<0.005);高血糖组中,脑出血高于脑梗死(51%,49%,χ2=9.12,P<0.005)。③重型百分率比较:白细胞增高组明显高于正常白细胞组(26%,6%,χ2=21.12,P<0.005);高血糖组明显高于正常血糖组(27%,5%,χ2=21.70,P<0.005)。④死亡百分率比较:白细胞增高组明显高于正常白细胞组(31%,6%,χ2=26.15,P<0.005);高血糖组明显高于正常血糖组(26%,5%,χ2=20.02,P<0.005)。结论:白细胞及血糖升高均损伤脑组织,可用其判断急性脑血管病患者的病情,估计预后并指导其治疗。
Background: Leukocytosis and hyperglycemia are a type of stress response to acute cerebrovascular disease and often occur in the early clinical stage of acute cerebrovascular disease. Objective: To observe the early stage of acute cerebrovascular disease, white blood cells, blood glucose levels, and explore its correlation with the recent prognosis. Design: based on the diagnosis, the patient as the object of observation prognosis analysis. Unit: Qingtian County People’s Hospital. PARTICIPANTS: A total of 235 patients with acute cerebrovascular disease admitted to Qingtian People ’s Hospital from May 2000 to May 2002. Among them, there were 90 cases of cerebral hemorrhage, including 52 males and 38 females, aged 63.13 ± 9.55 years of age; 145 cases of cerebral infarction, 73 males and 72 females, with age of 71.22 ± 8.00 years old. Duration ≤ 1 month. According to the number of leukocytes, 167 cases were divided into normal leukocyte group and 68 cases with leukocytosis group. According to blood glucose level, 146 cases were divided into normal blood glucose group and 89 cases with hyperglycemia group. Neurological deficit score was 0-15 points light, , Heavy 31 ~ 45 minutes snow. Methods: All patients were examined by skull CT immediately after admission. Fasting blood samples were collected on the morning of the next day for the determination of white blood cells and fasting blood glucose. Using χ2 test. MAIN OUTCOME MEASURES: ① The relationship between type and age of patients with acute cerebrovascular disease. ② type of acute cerebrovascular disease, disease, prognosis and the relationship between leukocytes and blood glucose. Results: ① Age comparison: The cerebral infarction group was significantly higher than that of the cerebral hemorrhage group (71.22 ± 8.00, 63.13 ± 9.55) years, t = 6.90, P <0.001. (2) The percentages of lesion type were higher in cerebral infarction than those in cerebral infarction (66%, 34%, χ2 = 31.47, P <0.005); in hyperglycemia group, cerebral hemorrhage was higher than cerebral infarction (51% 49%, χ2 = 9.12, P <0.005). (3) The percentage of severe type was significantly higher in leukocytosis group than in normal leukocyte group (26%, 6%, χ2 = 21.12, P <0.005); hyperglycemia group was significantly higher than that in normal glucose group (27%, 5% P <0.005). (4) The percentage of death was significantly higher in leukocytosis group than in normal leukocyte group (31%, 6%, χ2 = 26.15, P <0.005); the hyperglycemia group was significantly higher than that in normal glucose group (26%, 5% P <0.005). Conclusion: WBC and hyperglycemia all damage brain tissue, which can be used to judge the condition of patients with acute cerebrovascular disease, evaluate the prognosis and guide its treatment.