| Objective To explore the impacts of the abnormal glucose metabolism with acute stroke to the nerve injury and prognosis of stroke, in order to improve the clinical treatment and reduce complications and to provide scientific clinical evidence for control the risk factors.Methods To select 315 first acute stroke patients within 24 hours. The standard of stroke diagnosis accorded with the World Health Organization and were approved by CT or MRI. All the subjects were surveyed with questionnaires and collected the information on the general characteristics of patients,the next day fasting blood glucose,the risk factors of abnormal glucose metabolism on the phase of acute stroke and factors of the clinical features on prognosis of stroke, To compare the distribution of abnormal glucose metabolism of the factors. And 3 months after onset, 6-month follow-up of patients, according to NIHSS and modified Rankin Scale Rating Scale (mRS scale) for assessment, evaluation of different levels of abnormal glucose metabolism occurred prognosis of stroke patients. Multivariable Logistic regression analysis were applied to risk factors on abnormal glucose metabolism with acute stroke and risk factors on prognosis of stroke.Results A total of 315 subjects were enrolled into the study, in fact 287 subjects were completely finished, and the rate of follow-up was 91.1%. Among these subjects, there were 95 hemorrhagic stroke (33.1%), with an average age of (60.41±11.85); and 192 ischemic stroke (66.9%), with an average age of (57.12±12.48), There difference between the age of two types of stroke. In this study, the rate of in abnormal glucose metabolism with acute stroke were significantly higher, there were difference between hemorrhagic stroke,age≥65,female,NIHSS≥7,smoking,alcohol,hypertension,high cholesterol history and BMI≥30( P <0.05). The distribution of abnormal glucose metabolism based on impaired glucose tolerance were hemorrhagic stroke,male,smoking,drinking; based on diabetes were ischemic stroke,age≥65,hypertension,hyperlipidemia,NIHSS≥7,BMI≥30,There were difference between the constitutes of abnormal glucose metabolism (P <0.05). While, the coronary heart disease,atrial fibrillation,stroke family history was based on abnormal glucose metabolism. There were no statistically significant (P> 0.05). In order to further observe the role of the factors, to control the interference of confounding factors , The dependent variable was abnormal glucose metabolism, and age,sex,drinking,smoking,NIHSS,stroke type,hypertension,hyperlipidemia,coronary heart disease,atrial fibrillation,stroke family history,BMI and other risk factors as variables, Multiple logistic stepwise regression was used for a further analysis, showed that age,hyperlipidemia,NIHSS were risk factors. To the day of December 31, 2009, there were 270 subjects after three months follow-up and 256 subjects after six months follow-up. There difference between the types of abnormal glucose metabolism in the follow-up of 3 months, and 6 months in improvement,deterioration and death (P<0.05), with the level of glucose increased,the rate of improvement will be reduced, and the deterioration and mortality rates will be more higher. Correction affecting the prognosis of stroke risk factors, Multivariate Logistic stepwise regression analysis showed that abnormal glucose metabolism was independent risk factor of deterioration and death of stroke in three and six months. Those who were attacked by abnormal glucose had a risk of stroke 2.123 times than those who were normal glucose after three months, and its 95%CI was 1.479 to 4.573, the risk of six months was 1.598 times and 95%CI was 1.641 to 3.668.And the Patient's age,NIHSS were independent risk factors of the fatal stroke after three and six months.Conclusion The higher of the levels of abnormal glucose metabolism, the severity of the nerve injury. and the age≥65,hyperlipidemia,NIHSS≥7were the risk factors for abnormal glucose metabolism, and the abnormal glucose metabolism was independent risk factor of stroke. |
