卒中后高血糖患者采用强化降糖方案治疗对患者预后及血糖的影响

摘要

Objective This study investigated the effect of intensive hypoglycemic treatment on prognosis and blood glucose in patients with hyperglycemia after ischemic stroke. Methods A total of 120 patients with ischemic stroke and hyperglycemia were enrolled in our hospital from July 2016 to January 2018. 60 patients were given conventional hypoglycemic methods (control group), and another 60 patients were given intensive hypoglycemic method. NIHSS,modified Rankin score (mRS),daily living ability score (ADL) and blood glucose related indicators before and after treatment in two groups were compared. Results The differences of FPG,SBP and DBP in the two groups were not statistically significant before treatment (P ＞ 0.05). After the treatment of 24h,the FPG,SBP and DBP of the enhanced group were significantly lower than those of the control group (P ＜ 0.05). NIHSS scores of the two groups had no statistical significance before treatment (P ＞ 0.05). On the 7th day and 14th day after treatment,NIHSS scores of the intensive group were significantly lower than those of the control group (P ＜ 0.05). 3 months,6 months after treatment,the mRS score of the intensive group was significantly lower than that of the control group(P＜0.05),and the ADL score of the intensive group was significantly higher than that of the control group (P ＜ 0.05)-6,CRP levels were not statistically significant (P ＞ 0.05). After treatment,the levels of serum IL-6 and CRP in the intensive group were significantly lower than those in the control group(P＜0.05). Conclusion Patients with hyperglycemia after ischemic stroke treatment with intensive hypoglycemic treatment can effectively control blood glucose,thereby reducing stress response,improve neurological function and prognosis of patients.%目的 探讨缺血性卒中后伴高血糖患者采用强化降糖方案治疗对患者预后及血糖的影响.方法 选取2016年7月 ～2018年1月常州市金坛区人民医院收治的120例缺血性卒中后伴高血糖的患者,其中60例患者给常规降糖方法(对照组)、另外60例患者给予强化降糖方案(强化组),对比两组患者治疗前后的美国国立卫生研究院卒中量表评分(NIHSS)、改良Rankin评分(mRS)、日常生活能力评分(ADL)及血糖相关指标.结果 治疗前,两组患者的空腹血糖(FPG)、收缩压(SBP)、舒张压(DBP)组间比较,差异不具有统计学意义(P＞0.05),治疗24 h后,强化组的FPG、SBP、DBP均显著低于对照组,差异有统计学意义(P＜0.05).治疗前,两组患者的NIHSS评分差异不具有统计学意义(P＞0.05),治疗后7和14 d,强化组的NIHSS评分显著低于对照组,差异有统计学意义(P＜0.05).治疗3和6个月,强化组的mRS评分均显著低于对照组(P＜0.05),强化组的ADL评分显著高于对照组,差异有统计学意义(P ＜ 0.05).治疗前,两组患者的血清IL-6、CRP水平差异不具有统计学意义(P ＞0.05),治疗后,强化组的血清IL-6、CRP水平显著低于对照组,差异均有统计学意义(P＜0.05).结论 缺血性卒中后伴高血糖的患者采用强化降糖方案治疗能有效控制血糖,从而减轻患者应激反应、改善神经功能及患者的预后.