Szczudlik A, Slowik A, Turaj W, Wyrwicz-Petkow U, Pera J, Dziedzic T, Trabka-Janik E, Iskra T
Stroke Unit, Department of Neurology, Collegium Medicum, Jagiellonian University, ul. Botaniczna 3, 31-503 Cracow, Poland.
J Neurol Sci. 2001 Aug 15;189(1-2):105-11. doi: 10.1016/s0022-510x(01)00566-4.
The aim of the study was to investigate glucose derangement and its short- and long-term prognostic significance in nondiabetic ischemic stroke patients. The study involved 262 consecutive patients, mean age: 70.1+/-12.4 years, with a supratentorial ischemic stroke. The following data were collected: patients characteristics, risk factors, comorbidities, and stroke severity assessed by the Scandinavian Stroke Scale (SSS). Serum glucose levels were measured on admission, on the next, 2nd, 3rd, 5th, 7th and 14th day after stroke onset. The outcome measures on day 30 were mortality and capacity to perform daily activities: the Barthel Index and Rankin Scale. The 1-year survival was estimated by the Kaplan-Meier method. Cox proportional hazards regression was used to assess predictors of 1-year mortality in nondiabetics. Diabetes mellitus was found in 24.8% of patients and transient hyperglycemia in 36.3% of patients. Patients with transient hyperglycemia scored lower on SSS in the subsequent days of assessment than patients with either diabetes mellitus or normoglycemia. They had larger ischemic lesions on computer tomography (CT) than diabetics and had higher 30-day mortality than normoglycemics (p<0.05). One-year mortality was similar in transient hyperglycemics and diabetics, and both were significantly higher than in normoglycemics (p<0.05). A proportional hazards model analysis showed that transient hyperglycemia is not an independent predictor of death within a year after stroke.
本研究旨在调查非糖尿病性缺血性卒中患者的血糖紊乱情况及其短期和长期预后意义。该研究纳入了262例连续性患者，平均年龄为70.1±12.4岁，均为幕上缺血性卒中。收集了以下数据：患者特征、危险因素、合并症以及通过斯堪的纳维亚卒中量表（SSS）评估的卒中严重程度。在入院时、卒中发作后的次日、第2天、第3天、第5天、第7天和第14天测量血清葡萄糖水平。第30天的结局指标为死亡率和日常生活活动能力：巴氏指数和Rankin量表。采用Kaplan-Meier法估计1年生存率。使用Cox比例风险回归评估非糖尿病患者1年死亡率的预测因素。24.8%的患者患有糖尿病，36.3%的患者出现短暂性高血糖。在随后的评估日中，短暂性高血糖患者的SSS评分低于糖尿病患者或血糖正常的患者。他们在计算机断层扫描（CT）上的缺血性病变比糖尿病患者更大，30天死亡率高于血糖正常者（p<0.05）。短暂性高血糖患者和糖尿病患者的1年死亡率相似，且均显著高于血糖正常者（p<0.05）。比例风险模型分析表明，短暂性高血糖不是卒中后1年内死亡的独立预测因素。
