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中风后血糖异常与急性梗死体积增长:一项使用连续血糖监测的研究

Post Stroke Dysglycemia and Acute Infarct Volume Growth: A Study Using Continuous Glucose Monitoring.

作者信息

Shimoyama Takashi, Kimura Kazumi, Uemura Junichi, Saji Naoki, Shibazaki Kensaku

机构信息

Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan.

出版信息

Eur Neurol. 2016;76(3-4):167-174. doi: 10.1159/000448329. Epub 2016 Sep 20.

Abstract

BACKGROUND

The aim of the present study was to clarify the effect of glucose profiles after stroke, which was assessed by a continuous glucose monitoring (CGM) device.

METHODS

Acute ischemic stroke patients within 24 h of onset were prospectively studied. CGM was performed for 72 h after admission. CGM parameters were evaluated as follows: (1) mean glucose level, (2) area under the curve (AUC) for glucose level >140 mg/dl and (3) SD of the glucose level. Infarct volume was measured at admission and 24 and 72 h after admission using diffusion-weighted imaging. CGM data and infarct volume growth were compared at 24 and 72 h.

RESULTS

Seventy-eight patients were enrolled in the present study. Spearman's rank correlation coefficients showed that both the mean glucose level (r = 0.433, p < 0.001 for 24 h; r = 0.308, p = 0.006 for 72 h) and AUC >140 mg/dl (r = 0.417, p < 0.001 for 24 h; r = 0.277, p = 0.014 for 72 h) were significantly correlated with acute infarct volume growth. The SD of the glucose level was associated with infarct volume growth at 24 h (r = 0.303, p = 0.007), but not 72 h (r = 0.195, p = 0.088).

CONCLUSION

Post-stroke hyperglycemia was associated with infarct volume growth during the acute phase of ischemic stroke.

摘要

背景

本研究旨在阐明卒中后血糖曲线的影响,该影响通过连续血糖监测(CGM)设备进行评估。

方法

对发病24小时内的急性缺血性卒中患者进行前瞻性研究。入院后进行72小时的CGM。CGM参数评估如下:(1)平均血糖水平,(2)血糖水平>140mg/dl时的曲线下面积(AUC),以及(3)血糖水平的标准差。在入院时以及入院后24小时和72小时使用弥散加权成像测量梗死体积。比较24小时和72小时的CGM数据和梗死体积增长情况。

结果

本研究共纳入78例患者。Spearman等级相关系数显示,平均血糖水平(24小时时r = 0.433,p < 0.001;72小时时r = 0.308,p = 0.006)和AUC>140mg/dl(24小时时r = 0.417,p < 0.001;72小时时r = 0.277,p = 0.014)均与急性梗死体积增长显著相关。血糖水平的标准差在24小时时与梗死体积增长相关(r = 0.303,p = 0.007),但在72小时时无相关性(r = 0.195,p = 0.088)。

结论

卒中后高血糖与缺血性卒中急性期的梗死体积增长相关。

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