Objective To analyze the correlation between blood glucose variability and short-term poor prognosis in patients with diabetes mellitus and acute stroke. Methods 150 patients with diabetes mellitus complicated with acute stroke were selected from June 2015 to October 2018, and the clinical and follow-up data of all patients were analyzed retrospectively. According to the level of GluSD,the variation components of blood sugar were divided into three groups:low,medium and high. The levels of CGM and short-term prognostic indexes in blood glucose variation groups and the risk factors of short-term poor prognosis of diabetic patients with acute stroke were compared by multivariate Logistic regression analysis. Results The levels of GluMAGE,GluAve,GluCV,GluGLI,HbAlc and FPG in the blood glucose variation group were higher than those in the non-blood glucose variation group(P0.05). The levels of GluMAGE,GluAve, GluCV,GluGLI in the high score group were lower than those in the middle group(P0.05). In the low and middle quantile group,the NIHSS score was lower than that in the admission day,and the Barthl index and MoCA score were higher than those in the admission group(P0.05),and the NIHSS score increased at the 15th day after treatment with the increase of GluSD level,and the Barthl index and MoCA score decreased(P0.05),高分位组GluMAGE、GluAve、GluCV、GluGLI水平均较低、中位组高(P0.05);低、中分位组治疗15d时NIHSS评分均较入院时降低,Barthl指数、MoCA评分均较入院时升高(P0.05),且随着GluSD水平的上升在治疗15d时NIHSS评分呈升高趋势,Barthl指数、MoCA评分呈下降趋势(P<0.05);年龄(OR=1.764,95%CI:1.070~2.910)、HbAlc(OR=1.925, 95%CI:1.071~3.459)、NIHSS评分(OR=1.989,95%CI:1.107~3.575)、GluCV(OR=2.149,95%CI:1.303~3.543)、GluAve (OR=2.092,95%CI:1.164~3.758)是糖尿病合并急性期脑卒中患者短期不良预后的危险因素(P<0.05).结论 血糖变异性和糖尿病合并急性期脑卒中患者短期不良预后密切相关,临床上应控制血糖波动,有利于改善患者的预后.
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