摘要
目的分析非糖尿病脑卒中患者急性期血糖、血脂与认知功能障碍的关系，以期提高临床诊断和治疗水平，改善患者预后。方法测量251例急性期脑卒中患者的空腹血糖、血脂水平，应用简明精神状态量表（mini-mental state examination，MMSE）在入院后1—2周内评定认知功能。同时应用中国卒中量表神经功能缺损程度评分标准（1995）评定患者疾病严重程度。结果存在认知功能障碍的患者血糖水平明显高于无认知功能障碍的患者（6、22±1、04，5．64±0．86），P〈0．001。本研究中MMSE异常发生率24．3％（61／251），高血糖（〉6．1mmol／L）发生率29．5％（74／251）。认知功能正常与异常之间TC、HDL、LDL、TG差异无统计学意义，P〉0．05。区分脑梗死（163例）和脑出血（88例）后发现：脑梗死与脑出血之间HDL差异有统计学意义（1．19±O．31，1．29±0．35），P〈0．05；脑梗死与脑出血之间神经功能缺损程度评分差异有统计学意义（10．98±8、93，13．79±11．32），P〈0．05；脑梗死与脑出血之间的MMSE评分差异有统计学意义（24．12±5．37，22．55±5．72），P〈0．05。患者年龄、性别和受教育程度与是否存在认知功能障碍差异无统计学意义，P〉0．05。结论急性期脑卒中患者入院时血糖增高与认知功能障碍有关，认知功能障碍是脑卒中患者的常见并发症。
Objective To analyze the relationship between admission glucose level, cholesterol and cognitive impairment in nondiabetic patients with acute stroke for promoting the clinical diagnosis and treatment quality.Methods 251 acute stroke inpatients were diagnosed by CT or MRI from Feb.1997 to May 2004.The levels of glucose and serum total eholesterol（TC）, high-density lipoprotein （HDL）, low-density lipoprotein （LDL） and triglyceride （ TG ） were measured. Mini-mental state examination （ M MSE ） was used to evaluate their cognitive function.Results The patients with cognitive impairment had higher glucose level（ 〉 6. 1 mmol/L）compared with the patients with nonengnifive impairment（6.22 ± 1.04,5.64 ± 0.86）, P 〈 0.001 ,but there was no significant difference when compared with TC, HDL, LDL and TG（ P 〉 0.05 ）. The abnormal rate of MMSE was 24.3 % and the hyperglycemia was 29.5 %. According to the stroke types,the patients with iscbemie infarction had lower HDL and stroke impaired scores than the hemorrhagic strokes（ 1.19 ± 0.31,1.29 ± 0.35;10.98 ± 8.93,13.79 ±11.32）, P 〈 0.05, but had higher MMSE seures（ 24.12 ± 5.37,22.55 ± 5.72）, P 〈 0.05.Age, gender and educational level was no significant difference between the iscbemie and hemorrhagic strokes, P 〉 0.05. Conclusion Admission hy- perglycemia related to cognitive impairment for the patients with acute stroke. Cognitive impairment is a common complication in stroke patients.
出处
《四川医学》
CAS
2007年第2期130-132,共3页
Sichuan Medical Journal
基金
重庆市科委应用基础研究(41A11534)
关键词
脑卒中
血糖
血脂
认知功能障碍
简明精神状态量表
stroke
glucose
cholesterol
cognitive impairment
mlni-mental state examination
