摘要
目的探讨急性脑血管病(ACVD)患者皮质醇、血糖、糖化血红蛋白变化的机制及其临床意义。方法将78例ACVD患者按既往有无糖尿病史,分为糖尿病组(42例)、非糖尿病组(36例),另据病情程度分为轻型组(27例),中型组(31例),重型组(20例)。比较各组皮质醇(Cor)、24h尿游离皮质醇(24hUFC)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)的变化并分析其意义。结果1ACVD患者Cor、24hUFC、FBG及糖尿病组HbA1c显著高于正常对照组(P<0.01),而非糖尿病组HbA1c与正常对照组比较变化不明显(P>0.05)。2糖尿病组Cor、24hUFG、FBG、HbA1c显著高于非糖尿病组(P<0.01)。3ACVD重型组Cor、24hUFG、FBG、HbA1c显著高于轻、中型组(P<0.05)。4随着病情恢复,Cor、24hUFG、FBG、HbA1c明显下降(P<0.01)。结论1HbA1C、FBG、UFC的测定有助于鉴别应激性高血糖和糖尿病。2Cor、24hUFG、FBG、HbA1c与病情严重程度相关,可作为判断病情、估计预后的一个指标,对治疗有一定的指导意义。
Objective ：To study the changes of serum cortisol（Cor）,24hours urine free cortisol （24UFC）, fasting blood glucose （FBG）, and glycosylated hemoglobin （HbAlc） in acute cerebral vascular disease. Methods：78 patients with acute cerebral vascular disease were selected as subjects and 50 healthy persons were selected as controls. The subjects were divided into two groups with or without diabetes by past history. In adition,the diabetic subjects were divided into three groups by the NIHSS Scale Scores （NSS） . The levels of 8am and 5pm serum cortisol, 24hUFC,FBG and HbAlc were measured in all subjects and controls. Result：①The level of FBG,Cor and 24hUFC in subjects were statistically higher than the controls （P〈0. 01）. The levels of HbAlc in the group with diabetes was significantly higher than the controls （P〈0.01）. ② The levels of Cor 24hUFC, FBG, and HbAlc were significantly higher in the group with diabetes than those without diabetes （ P 〈0. 01）. ③ The levels of Cot 24hUFC, FBG, and HbAlc were statistically higher in those with highest NSS than those with less scores（P 〈0. 05）. ④ The levels of Cor 24hUFC, FBG, and HbAlc were significantly lower two weeks after treatment than before treatment （P 〈0. 01）. Conclusions： ① Measurement on Cor 24hUFC, FBG, and HbAlc is useful to distinguish response hyperglycemia from diabetes. ②The stress response during the acute phase of stroke causes the changes of the function of hypothalamus-pituitary-adrenal gland axon,which is the main reason of increasing in the level of Cor. So the level of Cor can be used to determine the severity of the acute stroke.
出处
《陕西医学杂志》
CAS
北大核心
2007年第4期445-448,共4页
Shaanxi Medical Journal
