Nair Sruthi S, Sylaja P N, Sreedharan Sapna Erat, Sarma Sankara
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Ann Indian Acad Neurol. 2017 Apr-Jun;20(2):122-126. doi: 10.4103/0972-2327.194301.
Several studies have shown that high admission glucose is associated with poor outcomes after stroke, but the impact of maintenance of normoglycemia on functional outcome during hospitalization for acute ischemic stroke is less well established.
The aim of this study was to examine the independent association of postadmission glycemic status in the 1 week with 3-month functional outcome in patients with acute ischemic stroke.
Patients with acute ischemic stroke admitted within 48 h of symptom onset with National Institutes of Health Stroke Scale (NIHSS) of ≥4 were selected from a prospectively maintained database by chart review. Demographic data, risk factors, NIHSS, and blood glucose values in the 1 week were collected. The primary outcome was Modified Rankin Scale (mRS) score at 3 months (good outcome-mRS ≤2).
Over 3 years, 342 patients were enrolled with 220 (64.32%) males. Mean age was 60.5 ± 13.4 years, and median admission score on NIHSS was 10 (interquartile range: 6-16). Blood glucose values persistently <140 mg/dl in the 1 week were associated with a good 3-month functional outcome in univariate analysis ( = 0.036). Hypoglycemic episodes occurred only in 11 (3.22%) patients.
Blood glucose values persistently below 140 mg/dl in the 1 week after acute ischemic stroke were associated with a favorable outcome in our study. Future clinical trials are needed to confirm these findings.
多项研究表明，入院时血糖高与卒中后预后不良相关，但急性缺血性卒中住院期间维持正常血糖对功能预后的影响尚不明确。
本研究旨在探讨急性缺血性卒中患者入院后1周血糖状态与3个月功能预后的独立相关性。
通过病历回顾，从一个前瞻性维护的数据库中选取症状发作后48小时内入院、美国国立卫生研究院卒中量表（NIHSS）评分≥4的急性缺血性卒中患者。收集人口统计学数据、危险因素、NIHSS评分以及入院后1周的血糖值。主要结局指标为3个月时的改良Rankin量表（mRS）评分（良好预后：mRS≤2）。
在3年多的时间里，共纳入342例患者，其中男性220例（64.32%）。平均年龄为60.5±13.4岁，NIHSS入院中位数评分为10（四分位间距：6-16）。单因素分析显示，入院后1周血糖值持续<140mg/dl与3个月良好的功能预后相关（P=0.036）。低血糖发作仅发生在11例（3.22%）患者中。
在我们的研究中，急性缺血性卒中后1周血糖值持续低于140mg/dl与良好预后相关。需要未来的临床试验来证实这些发现。
