The Study On The Relationship Between The Progressive Ischemic Stroke And The Blood Glucose Level

Background and Objectives:Progressive ischemic stroke(PIS),stroke in progression(SIP) for short,usually refers to after 6 hours from the happening of acute ischemic stroke,whether or not to receive the treatment,but the patients’ disease continues to deteriorate and even death.It is one of the refractory cerebrovascular disesae.The mortality and morbidity of SIP patients were higher than those of non-progressive stroke patients, and the treatment of SIP is also more difficult than the non-progressive stroke.So we should study on the risk factors of SIP and take the intervent ion measures early. They are important in reducing the moratality of acute cerebrovascular disease.This study aimed at the effects o f diabetes on the SIP.We researched the relationship between the development of SIP and the blood glucose and glycosylated hemoglobin levels through the comparision between SIP group and non SIP group. Methods :From September of 2014 to March of 2016,we selected 249 patients with acute ischemia cerebrovascular disease who were hospitalized in the department of neurology of the first hospital of Jilin University.There are 123 cases in SIP group and 126 cases in non SIP group among them.General clinical datas and the history of diabetes,random blood glucose,abdominal blood glucose,blood glucose of 2 hours after three meals,glycosylated hemoglobin of 249 patients were collected.Then according to the results,we make the results of stratification and do statistics.The presence of diabetes history is divided into non diabetes group,the history of diabetes less than 10 years,the history of diabetes more than 10 years.The random blood glucose is divided into low level group(random blood glucose<7.6mmol/L),medium level group(7.6mmol/L≤random blood glucose < 10.4mmol/L),high level group(random blood glucose≤10.4mmol/L).The fasting blood glucose is divided into low level group(blood glucose<6.4mmol/L),medium level group(6.4mmol/L≤blood glucose<7.5mmol/L),high level group(blood glucose≥7.5mmol/L).The two hours postprandial blood glucose is divided into low level group(blood glucose <7.7mmol/L),medium level group(7.7mmol/L≤blood glucose<11.3mmol/L),high level group(blood glucose≥11.3mmol/L).The Hb A1 c is divided into normal level group(Hb A1 c < 6.1%),low level group(6.1%≤Hb A1 c < 7.4%),high level group(Hb A1c≥7.4%). Results:(1)The gender and age had little effect on the occurrence of SIP.(2)The incidence of SIP in patients with history of diabetes was higher than that in patients without diabetes,and there was significant statistical significance(P<0.01).The incidence of SIP in patients with history of d iabetes more than 10 years was higher than that in patients with history of diabetes less than 10 years,and there was siginificant statistical significance(P<0.01).(3)When the random blood glucose≥10.4mmol/L, the incidence of SIP is the highest(P<0.01).The incidence of SIP in patients with random biood glucose from 7.6mmol/L to 10.4 mmol/L is lower than that in patients with random blood glucose<7.6mmol/L(P<0.05).When the range of random blood glucose is between 7.6mmol/L to 10.4mmol/L,the incidence of SIP is lower than the incidence of non-SIP.When the random biood glucose≥10.4 mmol/L,the incidence of SIP is higher than the incidence of non-SIP(P<0.01).(4)The incidence of SIP in patients with the fasting blood glucose≥7.5mmol/L is the highest(P<0.01).When the range of fasting blood glucose is between 6.4mmol/L to 7.5mmol/L,the incidence of SIP is lower than the incidence of non-SIP.When the fasting blood glucose≥7.5mmol/L,the incidence of SIP is higher than the incidence of non-SIP.(5)The incidence of SIP in patients with the two hours postprandial blood glucose≥11.3mmol/L is the highest(P<0.01).When the range of two hours postprandial blood glucose is between 7.7mmol/L to 11.3mmol/L,the incidence of SIP is lower than the incidence of non-SIP(P<0.05).When the two hours postprandial blood glucose≥11.3mmol/L,the incidence of SIP is higher than the incidence of nin-SIP(P<0.01).(6)The incidence of SIP in patients with Hb A1c≥7.4% is the highest(P<0.01).When Hb A1c≥7.4%,the incidence of SIP is higher than the incidence of non-SIP(P<0.01). Conclusions:(1) The incidence of SIP in patients with history of diabetes was higher than that in patients without diabetes.The incidence of SIP in patients with history of diabetes more than 10 years was higher than that in pat ients with history of diabetes less than 10 years.(2)When the random blood glucose≥10.4mmol/L,the incidence of SIP is the highest.When the random blood glucose<7.6mmol/L,the incidence of SIP is higher than that in a medium level.So when the range of random blood glucose is between 7.6mmol/L to 10.4mmol/L,it’s conductive to the prevention of stroke progression.(3)When the fasting blood glucose≥7.5mmol/L,the incidence of SIP is the highest.When the fasting blood glucose < 6.4mmol/L, no difference was found between the morbidity of SIP and non-SIP.When the fasting blood glucose is in a medium level,the incidence of SIP is lower than the incidence of non-SIP.So when the range of the fasting glucose was between 6.4mmol/L to 7.5mmol/L,it’s conductive to the preventin of stroke progression.(4)When the two hours postprandial blood glucose≥11.3mmol/L,the incidence of SIP is the highest.When the two hours pistprandial blood glucose<7.7mmol/L, no difference was found between the morbidity of SIP and non-SIP.When the two hours postprandial blood glucose is in a mediate level, the morbidity of SIP is lower than the morbidity of non-SIP.So when the range of the two hours postprandial blood glucose is between 7.7mmol/L to 11.3mmol/L,it’s conductive to the prevention of stroke progression.(5)When the Hb A1c≥7.4%,the incidence of SIP is the highest.When the Hb A1 c is in normal and low levels,no difference was found between the morbidity of SIP and non-SIP.So when Hb A1c<7.4%,it’s conductive to the prevention of stroke progression.