INCREASED DAMAGE AFTER ISCHEMIC STROKE IN PATIENTS WITH HYPERGLYCEMIA WITH OR WITHOUT ESTABLISHED DIABETES-MELLITUS
INCREASED DAMAGE AFTER ISCHEMIC STROKE IN PATIENTS WITH HYPERGLYCEMIA WITH OR WITHOUT ESTABLISHED DIABETES-MELLITUS
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DOI：
10.1016/0002-9343(83)91007-0
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发表时间：
1983-01-01
影响因子：
5.9
通讯作者：
PLUM, F
中科院分区：
文献类型：
--
作者：
PULSINELLI, WA;LEVY, DE;PLUM, F
采用控制程度的脑缺血的动物实验已经证明，升高的血脑葡萄糖浓度大大增强了随后的脑损伤的范围和程度。通过回顾性地将诊断为缺血性卒中的患者分为糖尿病组（n = 35）和非糖尿病组（n = 72），研究了是否存在类似的关系。通过将患者分为入院血糖水平高于（n = 14）或低于（n = 17）120 mg/dl的患者，对单独的非糖尿病缺血性卒中人群进行前瞻性分析。在回顾性研究中，出院时的神经系统状态用于将结局分层为良好、一般或差。在前瞻性研究中，能够或不能返回工作岗位被用来区分好的和差的结果。糖尿病脑卒中患者的神经功能预后明显差于非糖尿病患者（P < 0.05），糖尿病患者的脑卒中相关死亡人数也更多（P < 0.05）。在前瞻性研究中，高血糖水平的神经功能结局也更差，血糖值高于120 mg/dl的患者中只有43%恢复工作，而血糖值较低的患者中有76%重新就业（P = 0.061）。
Animal experiments employing controlled degrees of cerebral ischemia have demonstrated that elevated blood-brain glucose concentrations greatly enhance the extent and degree of subsequent brain damage. The question of whether or not a similar relationship applies in man was examined by retrospectively segregating patients admitted with the diagnosis of ischemic stroke into diabetic (n = 35) and nondiabetic (n = 72) groups. A separate nondiabetic population with ischemic stroke was prospectively analyzed by dividing patients into those with an admission blood glucose level above (n = 14) or below (n = 17) 120 mg/dl. The neurologic status at discharge was used to stratify outcome as good, fair or poor in the retrospective study. The ability or inability to return to work was used to separate good and poor outcomes in the prospective study. Neurologic outcome in diabetic patients with stroke was significantly worse (P < 0.05) than in nondiabetic patients and the diabetic patients had a greater (P < 0.05) number of stroke-related deaths. In the prospective study, neurologic outcome also was worse with high blood sugar levels, only 43% of the patients with blood glucose values above 120 mg/dl returned to work, whereas 76% of those with lower blood sugar values regained employment (P = 0.061).