STRESS HORMONE AND BLOOD-GLUCOSE RESPONSE FOLLOWING ACUTE STROKE IN THE ELDERLY
STRESS HORMONE AND BLOOD-GLUCOSE RESPONSE FOLLOWING ACUTE STROKE IN THE ELDERLY
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DOI：
10.1161/01.str.22.7.842
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发表时间：
1991-07-01
期刊：
影响因子：
8.3
通讯作者：
BENNETT, D
中科院分区：
文献类型：
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作者：
ONEILL, PA;DAVIES, I;BENNETT, D
我们研究了23例连续老年患者（中位年龄80岁[范围75-92岁]）急性首次卒中后反应性高血糖、应激激素反应与预后的关系。从中风发作到首次采血（第0天）的中位延迟时间为9小时（范围4-22小时）。随后在禁食后采集血样，测定第1、2、3、7、14、30和90天的血糖、皮质醇、儿茶酚胺、胰岛素、c肽、胰高血糖素和乳酸浓度。23例患者血糖浓度与生存期均有显著相关性（p = 0.03），且血糖浓度随时间延长而降低（p < 0.001）。血糖浓度与预后也有显著相关（p = 0.02）。对于15例数据完整的患者，血糖浓度的主要决定因素是皮质醇、胰岛素和胰高血糖素浓度（均p < 0.001），占方差的42%。综合logistic回归分析各项指标时，只有皮质醇浓度与预后相关（p = 0.02）。中风后的高血糖可能反映了应激激素反应的强度。我们已经证实，高血糖是中风患者预后的一个预测指标。
We studied the relation of reactive hyperglycemia, stress hormone response, and outcome in 23 consecutive elderly patients (median age 80 [range 75-92] years) following an acute first stroke. The median delay from the onset of the stroke to the first blood sample (day 0) was 9 (range 4-22) hours. Subsequent blood samples were taken, after fasting, for the determination of blood glucose, cortisol, catecholamine, insulin, C-peptide, glucagon, and lactate concentrations on days 1, 2, 3, 7, 14, 30, and 90. For all 23 patients, a significant relation was found between the blood glucose concentration and survival (p = 0.03) and the blood glucose concentration decreased with time (p < 0.001). There was also a significant relation between blood glucose concentration and outcome (p = 0.02). For the 15 patients with complete data, the major determinants of the blood glucose concentration were the cortisol, insulin, and glucagon concentrations (all p < 0.001), which accounted for 42% of the variance. When all the indexes were analyzed together by logistic regression, only the cortisol concentration was related to outcome (p = 0.02). Hyperglycemia following a stroke probably reflects the intensity of the stress hormone response. We have confirmed that hyperglycemia is a predictor of outcome in persons with stroke.