目的：探讨不同胰岛素方案治疗伴高血糖急性脑卒中的效果。方法本院2012年10月～2014年10月诊治的伴高血糖急性脑卒中患者90例，随机分两组，对照组45例行胰岛素常规治疗，观察组45例行胰岛素强化治疗。结果两组治疗后神经功能缺损评分、社会活动功能评分较治疗前显著降低，日常生活能力评分较治疗前显著增加。观察组神经功能缺损评分（8.1±1.5）分、社会活动功能评分（11.5±1.3）分、不良事件发生率2.2%均明显低于对照组（10.0±1.7）分、（13.8±1.6）分、13.3%，日常生活能力评分（71.2±4.5）分、治疗总有效率97.8%均明显高于对照组（60.1±5.2）分、86.7%，血糖达标时间（6.1±0.8）d，明显早于对照组（7.0±1.1）d，差异有统计学意义（P＜0.05）。结论胰岛素强化治疗伴高血糖急性脑卒中的疗效显著，可明显改善患者的临床病症，具有较高安全性，值得临床推广使用。%Objective To explore effect of different insulin schemes in treatment of acute stroke combined with hyperglycemia.Methods 90 patients with acute stroke combined with hyperglycemia who were admitted to our hospital from October 2012 to October 2014 were randomly allocated to the control group and the observation group, with 45 in each. The control group was received routine insulin treatment while the observation group was received intensive treatment of insulin.ResultsAfter treatment,neurological deficit scores and social activity function score of two groups were significantly decreased while daily living ability score was significantly increased compared with those before treatment.Neurological deficit scores,social activity function score and incidence of adverse reactions of the observation group were (8.1±1.5)points,(11.5±1.3)points and 2.2% respectively,all significantly lower than those of the control group (10.0±1.7)points,(13.8±1.6)points and 13.3%.Daily living ability score and total effective rate of the observation group were (71.2±4.5)points and 97.8% respectively, both significantly higher than those of the control group (60.1±5.2)points and 86.7%.But time of reaching standard of blood glucose of the observation group was (6.1±0.8)d,significantly earlier than that of the control group (7.0±1.1)d (P<0.05).Conclusion Insulin in intensive treatment of acute stroke combined with hyperglycemia has significant curative effect and higher safety and it can significantly improve clinical symptoms of patients,which is worthy of clinical promotion and application.
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