Association between the first poststroke random blood glucose levels and the severity and prognosis of stroke / 国际脑血管病杂志

ABSTRACT

Objective To investigate the relationship between the acute phase blood glucose and the severity and prognosis of stroke in patients with stroke. Methods One hundred seventy-three consecutive patients with acute stroke were randomly allocated into either a hyperglycemia group (n =72) or a normal group (n = 101) according to whether their random blood glucose levels were > 7.8 mmol/L or not. The average time from stroke onset to admis-sion was 6.5 ± 5.1 hours. The patients were evaluated by the National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Stroke (GCS) scores within 20 minutes after clinical reception, The plasma blood glucose detection and bead CT scan were completed in 40 minutes.The patients with cerebral infarction were classified according to the Oxfordshire Community Stroke Project (OCSP) criteria, and the survivors were evaluated by the modified Rankin scale (mRS) after 3 months. Results There were no significant differences between the two groups in age, gender, vascular risk factors, stroke property and treatment principle. There were significant differences between the NIHSS and GCS at the first admission and the mRS scores at 3 months (P<0.01). The proportion of the patients with the history of diabetic mellitus in the random hyperglycemia group was significantly higher than that in the normal group (P<0.01).The random blood glucose levels were not correlated with the severity of stroke between the 2 groups of patients with the history of diabetes mellitus; the increased random blood glucose levels were significantly correlated with the severity and prognosis of stroke between the 2 groups of patients without the history of diabetes mellitus (P<0.01). Conclusions The increased blood glucose in patients with stroke without the history of diabetes mellitus in acute phase is an independent risk factor for the severity and prognosis. The increased random blood glucose in patients with stroke in acute phase may also suggest having the history of diabetes mellitus.