Lee T H, Ryu S J, Chen S T
Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
J Formos Med Assoc. 1991 May;90(5):465-70.
We prospectively studied levels of blood glucose and glycohemoglobin, and their correlations with types, severity, and prognosis of stroke in 37 patients with brain infarction (BI) and 35 patients with brain hemorrhage (BH). We found that in the BH group, patients with an elevated glucose level due to stress, diabetes, or both, had a lower consciousness level on admission, larger hematoma size, higher incidence of rupture into the ventricles, and a worse 1-month outcome than patients with a normal glucose level (p less than 0.05). In patients with BI, however, no significant difference was found as related to levels of glucose, though a difference in 6-month mortality between stress hyperglycemic and normoglycemic patients (p less than 0.05) was found. We conclude that an elevated glucose level is associated with a worse clinical condition, larger hematoma size, higher incidence of rupture into the ventricles, and worse outcome in patients with BH. However, it seems to be the severity of the stroke, not the hyperglycemia, that causes the poor outcome. Hyperglycemia may be an epiphenomenon of stroke severity.
我们前瞻性地研究了37例脑梗死（BI）患者和35例脑出血（BH）患者的血糖和糖化血红蛋白水平，以及它们与中风类型、严重程度和预后的相关性。我们发现，在BH组中，因应激、糖尿病或两者导致血糖水平升高的患者，入院时意识水平较低，血肿体积较大，破入脑室的发生率较高，且1个月时的预后比血糖水平正常的患者差（p<0.05）。然而，在BI患者中，尽管发现应激性高血糖患者与血糖正常患者的6个月死亡率存在差异（p<0.05），但未发现血糖水平与中风相关的显著差异。我们得出结论，血糖水平升高与BH患者的临床状况较差、血肿体积较大、破入脑室的发生率较高以及预后较差有关。然而，似乎是中风的严重程度而非高血糖导致了不良预后。高血糖可能是中风严重程度的一种附带现象。
