| Objective:To explore the effect of blood glucose level on the curative effect of rt-pa intravenous thrombolysis on acute cerebral infarction.Methods:According to the inclusion and exclusion criteria,108patients with Acute ischemic stroke(ACI)who received rt-PA intravenous thrombolysis from January 2014 to December 2017 were collected.After admission,general data and biochemical data were collected.According to the random blood glucose level at admission,the patients were divided into normal blood glucose group,the high blood glucose I group and the hyperglycemia II group,the general data of the 3 groups of ACI patients were compared,and 3 groups were analyzed for differences in the general clinical data.Application of the United States National Institutes of Health Stroke Scale(National Institutes of Health Stroke Scale,NIHSS Scale),Modified Rankin Scale(MRS)rating Scale evaluation of the degree of nervous function defect and measure the status of the patients with nerve functional recovery after thrombolysis.Evaluation of early neurological defects:NIHSS score before thrombolysis and 24hNIHSS score after thrombolysis;clinical endpoint events included:mortality,bleeding conversion,and prognosis of 14d mRs score,compared to whether there was a statistical difference in the clinical endpoints of the three groups of patients with acute cerebral infarction.According to the hospital without diabetes,will be divided into subgroups according to blood sugar diabetes,high blood sugar group,diabetes-normal blood sugar group,diabetes,high blood sugar group,without diabetes-the high blood sugar group four groups.The prognosis of 14d mRs in diabetic patients with diabetes mellitus was compared with that of diabetic-normal blood glucose group.The prognosis of 14d mRs in patients with non-diabetic and hyperglycemic group was compared with those of non-hyperglycemic groupnon-diabetic.Logistic regression analysis was used to analyze the risk factors affecting prognosis.Results:1.Comparison of NIHSS scores before and after thrombolysis in the three groups of ACI patients showed that the P value of NIHSS before thrombolysis was greater than 0.05 in three groups;there was no significant difference;P value of NIHSS score was less than 0.05 after 24h after thrombolysis,and NIHSS score was 24h after thrombolysis are differences.After comparison between the two groups,the NIHSS score was significantly higher in hyperglycemic group Ⅱ at 24h after thrombolysis than in normoglycemic group,P=0.008<0.05;there was no difference between NIHSS score that hyperglycemic group I at 24h after thrombolysis and in hyperglycemia II group,P= 0.464>0.05;NIHSS score of 24 hours after thrombolysis in hyperglycemic group I was no difference with normal group,P = 0.347>0.05.2.The mRs scores>2-5 points after 14 days of thrombolysis in the three groups of AIC patients showed that there were 7 cases(16.3%)with mRs>2-5 points at 14 d after thrombolysis.In hyperglycemic group I,there were 11 cases(31.42%)of mRs score>2-5 after 14 d after thrombolysis.There was a significant difference in mRs score>2-5 points after 14 days of thrombolysis in the three groups of AIC patients,P=0.019<0.05.Comparing the two pairs,it was found that the hyperglycemia Ⅱ group had differences in mRs score>2-5 points after 14 days of thrombolysis compared with the normoglycemic group,P = 0.005<0.05.In the hyperglycemia Ⅱ group,there was no difference in mRs score>2-5 points after 14 days of thrombolysis compared with hyperglycemic Ⅰ group,P = 0.242>0.05.In the hyperglycemic group Ⅰ,there was no difference in the mRs score>2-5 points after 14 days of thrombolysis compared with the normoglycemic group(P-0.114>0.05).3.The results of hemorrhagic transformation during hospitalization in three groups of ACI patients were as follows:2 patients(4.76%)with hemorrhagic transformation in the normoglycemic group,2 patients(5.71%)with hemorrhagic transformation in the hyperglycemic I group,and 3 patients(10%)in the hyperglycemic II group.The proportion of hemorrhagic transformation in patients with hyperglycemia II group>patients with hyperglycemic I group>patients with normoglycemic group,but calculated P = 0.437>0.05,there was no difference in the hemorrhage conversion rate between the three groups.After a pairwise comparison between groups,it was found that there was no statistical difference between each group.In 108 patients,there were 6 deaths in total,2 deaths(4.8%)in the normoglycemic group,1 death(2.86%)in the hyperglycemic group I,and 3 deaths(10%)in the hyperglycemic group II,P = 0.503>0.05,and there was no significant difference in the mortality rate of the three groups.After the two groups were compared,it was found that there was no statistical significance between the two groups.4.Based on the presence or absence of diabetes,108 patients were divided into diabetes-normal blood glucose group,diabetes-hyperglycemic group,non-diabetic-normal blood glucose group,non-diabetic-hyperglycemia Group 4 groups.After comparison between groups,it was shown:1.For the diabetic group,16 patients(66.70%)had an mRs score of>2-5 on the 14th day after thrombolysis in the diabetes-hyperglycemic group,and 2 cases(30%)had an mRs scores of>2-5 on 14th day after thrombolysis in diabetes-.The comparison between the two groups showed:P = 0.013(0.035 after correction),and the difference was statistically significant.2.For the non-diabetic group,non-diabetic-high blood glucose group had 18 cases(54.54%)with mRs score>2-5 points after 14 days of thrombolysis,and non-diabetic-normal blood glucose group had five patients(12.20%)with mRs score>2-5 points after 14 days of thrombolysis.A comparison between the two groups showed:P=0.00<0.05,and the difference was statistically significant.Conclusions:1.Three groups of patients with acute cerebral infarction undergoing rt-PA thrombolytic therapy had an effect on the therapeutic effect of pre-thrombolytic blood glucose levels.The higher the blood glucose,the heavier the neurological deficits remained after 24 hours of thrombolysis.2.In patients with acute cerebral infarction undergoing rt-PA thrombolysis,blood glucose levels before thrombolysis had an effect on the degree of neurological function recovery 14 days after thrombolysis.The higher the blood glucose level,the worse the neurological function recovery after 14 days of thrombolysis.3.In patients with acute cerebral infarction undergoing rt-PA thrombolytic therapy,blood glucose levels before thrombolysis had no effect on hospital deaths and hemorrhage conversion rates.4.1n 108 acute cerebral infarction patients undergoing rt-PA thrombolytic therapy,regardless of diabetes,the higher the blood glucose level before thrombolysis,the worse the recovery of neurological function after 14 days of thrombolysis. |
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