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急性中风患者的血糖和血脂评估

Glucose and lipid assessment in patients with acute stroke.

作者信息

Ogbera Anthonia O, Oshinaike Olajumoke O, Dada Olusola, Brodie-Mends Ayodeji, Ekpebegh Chukwuma

机构信息

Department of Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria.

Department of Internal Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape Province South Africa.

出版信息

Int Arch Med. 2014 Oct 23;7(1):45. doi: 10.1186/1755-7682-7-45. eCollection 2014.

Abstract

BACKGROUND

Stroke is a major health issue in Nigeria and it is also a common cause of emergency admissions. Stroke often results in increased morbidity, mortality and reduced quality of life in people thus affected. The risk factors for stroke include metabolic abnormalities such as dyslipidaemia and diabetes mellitus (DM). The stress of an acute stroke may present with hyperglycaemia and in persons without a prior history of DM, may be a pointer to stress hyperglycaemia or undiagnosed DM.

METHODOLOGY

This was a cross sectional study carried out over a period of one year in a teaching hospital in Lagos, Nigeria. Patients with acute stroke admitted to the hospital within three days of the episode of stroke and who met other inclusion criteria for the Study were consecutively recruited. Clinically relevant data was documented and biochemical assessments were carried out within three days of hospitalization. Tests for lipid profile, glycosylated haemoglobin(HbA1c), and blood glucose at presentation were carried out. The presence of past history of DM, undiagnosed DM, stress hyperglycaemia and abnormal lipid profile were noted. Students t test and Chi square were the statistical tests employed.

RESULTS

A total of 137 persons with stroke were recruited of which 107 (76%) met the defining criteria for ischaemic stroke. The mean age and age range of the Study subjects were 62.2 (11.7) and 26-89 years respectively. The Study subjects were classified according to their glycaemic status into the following categories viz; stress hyperglycaemia, euglycaemia, DM and previously undiagnosed DM. Stress hyperglycaemia occurred commonly in the fifth decade of life and its incidence was comparable between those with cerebral and haemorrhagic stroke. The commonly occurring lipid abnormalities were elevated LDL-C and low HDL.

CONCLUSIONS

The detection of abnormal metabolic milieu is a window of opportunity for aggressive management in persons with stroke as this will improve outcome. Routine screening for hyperglycaemia in persons with stroke using glycosylated haemoglobin tests and blood glucose may uncover previously undiagnosed DM.

摘要

背景

中风是尼日利亚的一个主要健康问题,也是急诊入院的常见原因。中风常常导致患者发病率和死亡率上升,生活质量下降。中风的危险因素包括代谢异常,如血脂异常和糖尿病(DM)。急性中风的应激反应可能表现为高血糖,对于既往无糖尿病史的患者,这可能提示应激性高血糖或未被诊断的糖尿病。

方法

这是一项在尼日利亚拉各斯一家教学医院进行的为期一年的横断面研究。连续招募在中风发作三天内入院且符合本研究其他纳入标准的急性中风患者。记录临床相关数据,并在住院三天内进行生化评估。进行血脂谱、糖化血红蛋白(HbA1c)和入院时血糖检测。记录既往糖尿病史、未被诊断的糖尿病、应激性高血糖和血脂异常情况。采用学生t检验和卡方检验作为统计方法。

结果

共招募了137名中风患者,其中107名(76%)符合缺血性中风的定义标准。研究对象的平均年龄和年龄范围分别为62.2岁(11.7)和26 - 89岁。研究对象根据血糖状态分为以下几类:应激性高血糖、血糖正常、糖尿病和既往未被诊断的糖尿病。应激性高血糖常见于50岁左右,在脑卒中和出血性中风患者中的发生率相当。常见的血脂异常是低密度脂蛋白胆固醇(LDL-C)升高和高密度脂蛋白(HDL)降低。

结论

检测异常的代谢环境是对中风患者进行积极治疗的契机,因为这将改善预后。使用糖化血红蛋白检测和血糖对中风患者进行常规高血糖筛查可能会发现既往未被诊断的糖尿病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d3/4221686/0f3026360973/13038_2014_265_Fig1_HTML.jpg

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