糖尿病前期脑出血患者的临床特征及预后分析

Clinical characteristics and prognosis of prediabetic patients with cerebral hemorrhage

  • 摘要:
    目的 探讨糖尿病前期脑出血患者的临床特征及远期预后。
    方法 回顾性分析165例脑出血患者的资料, 依据血糖结果分为糖尿病前期组56例和糖代谢正常组109例, 比较2组基线资料及临床特征,依据改良Rankin量表(mRS)评估发病后1年的预后情况。
    结果 脑出血预后不良与年龄、血肿量、破入脑室、血肿扩大、美国国立卫生研究院卒中量表(NIHSS)评分、并发感染、C反应蛋白(CRP)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)等有关。与糖代谢正常组相比,糖尿病前期组除了入院后的HbA1c外,其他基线资料比较差异均无统计学意义(P>0.05)。脑出血后,糖尿病前期组更容易出现血肿量增大、NIHSS评分升高、破入脑室及并发感染状况。糖尿病前期组脑出血预后不良发生率为71.43%, 高于糖代谢正常组的32.11%, 差异有统计学意义(P < 0.05)。
    结论 糖尿病前期脑出血患者病情更重,预后更差,临床需关注糖尿病前期脑出血患者的临床表现。

     

    Abstract:
    Objective To explore the clinical characteristics and long-term prognosis of patients with prediabetic cerebral hemorrhage.
    Methods One hundred and sixty-five patients with intracerebral hemorrhage were retrospectively analyzed. According to the blood glucose levels, patients were classified as prediabetes group(n=56) and normal glucose metabolism group(n=109). The baseline data and clinical characteristics were compared between two groups. The modified Rankin scale(mRS) was used to evaluate the prognosis at 1 year poststroke.
    Results The poor prognosis of intracerebral hemorrhage was related to age, hematoma volume, ventricle rupture, hematoma enlargement, National Institutes of Health Stroke Scale (NIHSS) score, concurrent infection, C-reactive protein (CRP), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), etc. Compared with the normal glucose metabolism group, in addition to the increased HbA1c after admission, the baseline data of the prediabetic group showed no statistically significant difference. However, after intracerebral hemorrhage, the prediabetic group had larger hematoma volume, higher NIHSS score, higher incidence of rupturing into ventricle and accompanying infection. The incidence of poor prognosis in the prediabetic group was higher than that in the normal glucose metabolism group (71.43% versus 32.11%, P < 0.05).
    Conclusion Prediabetic patients with cerebral hemorrhage have more severe condition and worse prognosis. Clinical attention should be paid to clinical manifestations in patients with prediabetic cerebral hemorrhage.

     

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