关键词: 缺血性脑血管病；高血糖；随机血糖；空腹血糖；预后

Abstract:

Objective  To determine  the forecasting value of postadmission hyperglycemia on prognosis of ischemic cerebrovascular disease. Methods  150 patients with a first ischemic stroke and without prior diagnosis of diabetes mellitus were enrolled. Random plasma glucose levels were measured on admission and fasting glucose on days 1, 2, 3, 5 and 7. Hyperglycemiaon admission was defined as a glucose level ≥7.8mmol/L. Postadmission hyperglycemia was diagnosed if the mean postadmission fasting glucose level was≥6.1mmol/L. Results  After multivariable adjustment, postadmission hyperglycemia was associated with higher risk of death.（ 95%CI: 1.39-2.86, P<0.01), no matter finche admission hyperglycemia group or the admission normoglycemia group (HR: 4.83, 95%CI: 1.93-12.06, P<0.01; HR: 1.64, 95%CI: 1.06-2.54, P=0.03).  In patients with admission hyperglycemia, glucose normalization after admission was associated with reduced risk of death compared to those with persistent hyperglycemia (HR: 0.21, 95%CI: 0.08-0.52). The patients who were normoglycemic on day 1 and developed hyperglycemia in the next days had an increased risk of death compared to persistent normoglycemic patients (HR: 1.55, 95%CI: 1.01-2.39, P=0.04). Conclusions  Postadmission  hyperglycemia is associated with increased risk of death and has a forecasting value on prognosis of ischemic cerebrovascular disease. Glucose normalization after admission is associated with higher survival rate.

Key words: Ischemic cerebrovascular disease；Hyperglycemia; Random plasma glucose; Fasting glucose level; Prognosis