Cox N H, Lorains J W
Postgrad Med J. 1986 Jan;62(723):7-10. doi: 10.1136/pgmj.62.723.7.
In a prospective study of 109 patients admitted to hospital with a provisional diagnosis of acute stroke, 87 were found to have acute hemiplegic stroke lasting more than 24 hours, and did not have any other co-existing life-threatening disorder. In 81 of these patients, blood glucose and glycosylated haemoglobin (HbA1) were measured at the time of admission. Thirteen of these 81 patients (16%) were hyperglycaemic--in 5 cases, normal HbA1 was found in conjunction with hyperglycaemia suggesting that this represented a 'stress' response. There was no significant difference in age or in blood glucose level between those who died as a result of stroke and those who survived. However, hyperglycaemia with normal HbA1 was demonstrated in 4 of 26 patients who died compared to only one of 55 survivors (P less than 0.02), and all 3 patients with blood glucose greater than 10 mmol/l in conjunction with normal HbA1 died as a result of stroke. Biochemical evidence of 'stress' hyperglycaemia in patients with acute stroke suggests a poor prognosis.
在一项针对109例初步诊断为急性中风入院患者的前瞻性研究中，发现87例患有持续超过24小时的急性偏瘫性中风，且无其他并存的危及生命的疾病。在这些患者中的81例中，入院时测量了血糖和糖化血红蛋白（HbA1）。这81例患者中有13例（16%）血糖过高——在5例中，血糖过高的同时HbA1正常，提示这代表一种“应激”反应。因中风死亡者与幸存者在年龄或血糖水平上无显著差异。然而，26例死亡患者中有4例出现血糖过高且HbA1正常，而55例幸存者中只有1例（P<0.02），并且所有3例血糖大于10 mmol/l且HbA1正常的患者均死于中风。急性中风患者“应激”性血糖过高的生化证据提示预后不良。
