| Background and objective :Stroke is one of the most important causes of death in contemporary society, and many stroke survivors will live with severe disabilities. And ischemic stroke accounts for 70-85% of brain stroke. The early diagnosis of acute brain stroke, can enable clinicians to make quick treatment decisions, thereby helping to reduce the mortality rate [1]. A lot of researches have suggested that high blood glucose levels of cerebrovascular diseaseare closely associated with poor stroke outcome [2]. This study attempts to explore the effect of acute phase of cerebral infarction with diabetes, the normal blood glucose in patients with diabetes and acute hyperglycemia in patients with cerebral infarction on the characteristics and clinical outcome, from the end of infarction volume, vascular stenosis degree, collateral circulation and perfusion level comparison.Methods:Collected from January 2014 to May 2015 for the first time in changhai hospital treatment of cerebral infarction patients(points anterior circulation and posterior circulation) 154 cases, 108 cases of men and women in 46 cases; According to the comorbidity of type 2 diabetes and acute stage blood sugar levels,patients were divided into normal blood glucose group(group A), diabetes(group B), fasting hyperglycemia group(group C); Ask the patient and close family history record or after admission, cerebral infarction disease before the presence of TIA(TIA responsible blood vessels and brain infarcts ipsilateral or contralateral); All patients were treated according to the current cerebral infarction treatment guidelines. Suitable patients received thrombolysis within 4.5h time window, and those whose symptoms did not improve and who were within 4.5-8h time window received endovascular intervention. Patient beyond endovascular treatment time window received medical intervention. line immediately when the onset of cranial CT, blood sugar and other biochemical examination, perfect the CTA+CTP check, 3d ball head MRI imaging measurement of cerebral infarction volume, comparison between groups of infarction volume, large extent of vascular stenosis and determined by MTT, TTP, degree of collateral circulation(ACG), using the correlation ofbinary linear regression adjusting for other risk factors.Results:1.The infarct volume area between three groups of patients with significant difference(p < 0.05), normal blood sugar group(1.9(1.5 2.9)), diabetes mellitus group(4.5(2.85 6.99)).After adjusting for age and other factors, there were significant differences, normal blood sugar group patients(mean 2.356) and fasting hyperglycemia(5)(3.43, 6.8) on infarct size in patients also have obvious difference, the difference was statistically significant(p < 0.05). Diabetes and acute hyperglycemia group on the infarct volume has no obvious statistically significant difference(P > 0.05).2.The three groups of patients, only in normal blood sugar group with and withoutTIA TIA K- two subgroups of patients W test suggest two sets of infarction volume hadsignificant difference(P < 0.05).3.The vascular stenosis degree, the three groups have obvious difference, after adjustment for age and other factors, the difference among three groups was statistically significant(p < 0.05), two K- W test between the two groups, all have significant difference,(p < 0.05), degree of stenosis of acute hyperglycemia group > diabetes group > normal group.4.Perfusion level results, after adjustment for age and other factors, determined by MTT, the delay of TTP degree are characterized by the degree of acute hyperglycemia group and diabetes group delay is greater than the normal group(P < 0.05), the difference was statistically significant, but the differences between acute hyperglycemia group and diabetes group was not obvious(P > 0.05).5.DSA prove assessment of collateral circulation, all have significant differenceamong three groups(P < 0.05), two comparison, normal blood sugar group and collateralcirculation in diabetes group were superior to acute hyperglycemia group(P < 0.05).Conclusions1.Patients with diabetes and acute hyperglycemia, statistics on infarct volume wassignificantly higher than normal group. Group of diabetes incidence after theperformance of the cycle is more than the other groups, infarction areas relativelyscattered, non-diabetic acute hyperglycemia in patients with onset before the cycle isrelatively common, see more, in the form of large vascular occlusion responsibilityvascular stenosis degree of acute hyperglycemia group obviously higher than that ofdiabetes and normal blood sugar group.2.The comparison of perfusion degree of delay, diabetes and acute hyperglycemia group is not obvious, delay in two groups were significantly higher than normal blood sugar group; But the open degree of collateral circulation of diabetes group was superior to that of acute hyperglycemia group.3.For IP mechanisms, without diabetes patients with normal blood sugar, cerebral infarction before the onset of TIA can produce the protective effects of ischemic preconditioning, but this protective effect is not obvious, diabetes mellitus patients and non-diabetic patients with acute hyperglycemia form heavy, almost no form of TIA attack, even exist, such as IP mechanism can hardly bring benefits, the cerebral infarction occurred end is also the most serious. |
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