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J Neurol:血糖控制对脑缺血患者静脉溶栓治疗预后的影响

2015-08-19 phylis 译 MedSci原创

脑缺血发生后溶栓治疗的一小时内是否血糖控制,是否影响预后尚不清楚。我们主要想评估血糖控制水平以及急性脑缺血溶栓后血糖控制良好的患者是否有较好的预后。在里尔大学医院,我们回顾性分析了预先收集的一些进行静脉溶栓的卒中病人。卒中后的前48h内,任意时刻的血糖高于1.6 g/l (8.9 mmol/l)患者给予胰岛素治疗。血糖控制良好的两个定义:ⅰ良好控制100%,即血糖100%低于1.6&nb

脑缺血发生后溶栓治疗的一小时内是否血糖控制,是否影响预后尚不清楚。我们主要想评估血糖控制水平以及急性脑缺血溶栓后血糖控制良好的患者是否有较好的预后。在里尔大学医院,我们回顾性分析了预先收集的一些进行静脉溶栓的卒中病人。

卒中后的前48h内,任意时刻的血糖高于1.6 g/L(8.9 mmol/L)患者给予胰岛素治疗。血糖控制良好的两个定义:ⅰ良好控制100%,即血糖100%低于1.6 g/L (8.9 mmol/L)。ⅱ良好控制70%,即至少70%的血糖低于1.6 g/L (8.9 mmol/L)。3个月预后分四个层次:(1)独立(mRS为0或1);(2)缺乏障碍(mRS为0-2);(3)死亡;(4)有症状的脑内出血。

875名患者中,657(75.2%)的患者血糖控制属ⅰ良好控制,736(84.2%)患者血糖控制属ⅱ良好控制。血糖控制并非与任意四种预后完全无关。应用胰岛素的患者,低血糖发生率较少(占2.1%患者),并且低血糖属于中等程度,血糖高于0.5 g/L (2.8 mmol/L)。血糖控制的水平与病人溶栓治疗预后无关。相关可能的解释是:与在溶栓前进行血糖控制相比,溶栓后血糖控制有着较小的作用。因为,溶栓前动脉尚未再通,梗死面积仍是最大。

原文出处:

Litke R, Moulin S, Cordonnier C, Fontaine P, Leys D. Influence of glycaemic control on the outcomes of patients treated by intravenous thrombolysis for cerebral ischaemia.J Neurol. 2015 Aug 15.

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    2015-12-21 仁医06
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    2016-05-16 fusion
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    2015-08-21 lqvr
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