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高血糖与急性自发性脑出血预后之间的关联。

The association between hyperglycemia and the prognosis of acute spontaneous intracerebral hemorrhage.

作者信息

Zhao Yanxia, Yang Jie, Zhao Hongdong, Ding Yunlong, Zhou Junshan, Zhang Yingdong

机构信息

a Department of Neurology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China.

b Department of Neurology , Jingjiang People's Hospital , Jingjiang , China.

出版信息

Neurol Res. 2017 Feb;39(2):152-157. doi: 10.1080/01616412.2016.1270575. Epub 2016 Dec 26.

Abstract

OBJECTIVE

To evaluate the potential association between the plasma glucose levels and the 90-day prognosis in patients with spontaneous intracerebral hemorrhage (sICH).

METHODS

Patients with a well-defined diagnosis of sICH admitted within 24 h of onset were included. Random plasma glucose at admission and fasting plasma glucose on the following day were measured. Hyperglycemia was defined as a random plasma glucose ≥10 mmol/L or a fasting plasma glucose ≥7 mmol/L. Neurological severity at admission was assessed using the National Institutes of Health Stroke Scale (NIHSS). Functional outcomes were evaluated using modified Rankin Score (mRS) at three months after onset. Potential correlations between plasma glucose levels and neurological severity or functional outcomes values were assessed on Spearman's correlation analysis. Multivariable logistic regression analyses were performed to identify whether there were independent risk factors for 90-day outcomes after sICH.

RESULTS

228 consecutive adult patients with a mean age of 62.4 ± 12.9 years were prospectively enrolled. No significant association was observed between the random glucose levels (r = 0.108, p = 0.146) or fasting glucose levels (r = 0.116, p = 0.098) with functional outcomes at 90 days after discharge. However, hyperglycemia was associated with the neurological severity of sICH, both random glucose levels (r = 0.183, p = 0.009)and fasting glucose levels (r = 0.133, p = 0.045). On logistic regression analyses, age and NIHSS values at admission were independently associated with poor outcomes.

CONCLUSION

Hyperglycemia was associated with neurological severity of sICH, but not with 90-day outcomes.

摘要

目的

评估自发性脑出血(sICH)患者血浆葡萄糖水平与90天预后之间的潜在关联。

方法

纳入发病24小时内确诊为sICH的患者。测量入院时的随机血糖和次日的空腹血糖。高血糖定义为随机血糖≥10 mmol/L或空腹血糖≥7 mmol/L。入院时的神经功能严重程度采用美国国立卫生研究院卒中量表(NIHSS)进行评估。发病三个月后使用改良Rankin量表(mRS)评估功能结局。通过Spearman相关性分析评估血浆葡萄糖水平与神经功能严重程度或功能结局值之间的潜在相关性。进行多变量逻辑回归分析,以确定sICH后90天结局的独立危险因素。

结果

前瞻性纳入了228例连续的成年患者,平均年龄为62.4±12.9岁。出院后90天时,随机血糖水平(r = 0.108,p = 0.146)或空腹血糖水平(r = 0.116,p = 0.098)与功能结局之间未观察到显著关联。然而,高血糖与sICH的神经功能严重程度相关,随机血糖水平(r = 0.183,p = 0.009)和空腹血糖水平(r = 0.133,p = 0.045)均如此。逻辑回归分析显示,年龄和入院时的NIHSS值与不良结局独立相关。

结论

高血糖与sICH的神经功能严重程度相关,但与9​​0天结局无关。

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