Woo E, Chan Y W, Yu Y L, Huang C Y
Department of Medicine, University of Hong Kong, Queen Mary Hospital.
Stroke. 1988 Feb;19(2):185-91. doi: 10.1161/01.str.19.2.185.
In a prospective study to correlate admission glucose level with neurologic outcome in stroke, 252 acute stroke patients without prior disability and admitted within 24 hours of onset of ictus were assessed. The stroke was classified into one of three types--cortical infarct, lacunar infarct, or intracerebral hemorrhage--by clinical, computed tomographic, and necropsy findings. Fifty-one diabetic patients were excluded from the entire cohort to form a nondiabetic category for analysis. We found that admission glucose level showed a significantly higher degree of correlation with mortality and morbidity (measured as arm function, leg function, and activities of daily living) when cortical (n = 118) and lacunar (n = 58) infarcts were pooled compared with when they were assessed separately. For intracerebral hemorrhage (n = 76), admission glucose level correlated with mortality but not morbidity. This trend persisted despite exclusion of diabetic patients. These results are consistent with previous observations of a correlation between a high admission glucose level and the severity of stroke. The importance of segregating cortical from lacunar infarcts, two groups with a different natural history and prognosis, in any future analysis is emphasized.
在一项旨在关联卒中患者入院时血糖水平与神经功能转归的前瞻性研究中，对252例既往无残疾且在发病24小时内入院的急性卒中患者进行了评估。根据临床、计算机断层扫描和尸检结果，将卒中分为三种类型之一——皮质梗死、腔隙性梗死或脑出血。51例糖尿病患者被排除在整个队列之外，以形成一个非糖尿病类别进行分析。我们发现，与分别评估时相比，当将皮质梗死（n = 118）和腔隙性梗死（n = 58）合并在一起时，入院血糖水平与死亡率和发病率（以手臂功能、腿部功能和日常生活活动来衡量）的相关性显著更高。对于脑出血（n = 76），入院血糖水平与死亡率相关，但与发病率无关。尽管排除了糖尿病患者，这一趋势仍然存在。这些结果与先前关于高入院血糖水平与卒中严重程度之间相关性的观察结果一致。强调了在未来的任何分析中区分皮质梗死和腔隙性梗死这两个具有不同自然病史和预后的组别的重要性。
