The Clinical Significance Of Blood Glucose And Cerebrospinal Fluid Glucose Level Changes In Patients With Aneurysmal Subarachnoid Hemorrhage

Objective: To determine the level of blood glucose and cerebrospinal fluid(CSF)glucose in patients with aneurysm subarachnoid hemorrhage(aSAH)and to explore its clinical significance.Method:This study is included in the period from September 2016 to September2018,diagnosis of aSAH in 116 patients,the total age is 60.50(52.00,71.00)years old,twenty-one of them died after admission,and Cerebral vasospasm(CVS)occurred in 18 patients.They were classificationed based on admission Hunt-Hess scale(H-H),among them,48 patients were in general condition,and 68 patients were in serious condition.According to the modified Rankin scale(mRS)score of 90 days after discharge,the prognosis of the patients was classified.Among them,47 patients had good prognosis and 48 patients had poor prognosis.The patients were divided into groups according to whether they died,whether they were seriously admitted to hospital,whether the prognosis was good or not,Whether CVS occurs or not,and the general baseline data and clinical observation indexes were recorded,and further statistical analysis was carried out.Result:There were significant differences in admission blood glucose(Blood-GluAdm),H-H score and GCS score between the dead group and the non-dead group,and there was a significant difference between the two groups(P<0.05),Multivariate Logistic regression analysis showed a significant correlation between Blood-GluAdm and mortality during hospitalization(OR=0.437,CI:0.305-0.627,P < 0.001);There was significant difference in MFS score and Blood-GluAdm group between the severe group and the general group.Multivariate Logistic regression analysis showed that there was a significant difference between the two groups(P<0.05),and there was a significant difference between the two groups(P<0.05).The admission MFS score(OR=4.315,CI:1.724-10.796,P=0.002)and Blood-GluAdm(OR=0.731,CI:0.573-0.917,P=0.007)were significantly correlated with the patient’s admission condition;the area under the receiver operating characteristic curve(ROC)was 0.847,and 95% confidence interval was 0.748 and 0.947,P<0.05;between poor prognosis group and good prognosis group,age,maximum blood glucose(Blood-GluMax),mean blood glucose(Blood-GluAve),CSF maximum sugar(CSF-GluMax),CSF sugar mean(CSF-GluAve),CSF sugar standard deviation(CSF-GluSD),the average CSF glucose / blood glucose(CSF-Glu/Blood-Glu)was significantly different between the two groups(P < 005),Multivariate Logistic regression analysis showed that Blood-GluAve(OR=7.221,CI:1.232-42.310,P=0.028)and the mean CSF-Glu/Blood-Glu(OR=5.448,CI:1.696-17.499,P=0.004)were significantly correlated with the prognosis of patients with aSAH,the area under the Blood-GluAve ROC curve was 0.748,the 95%confidence interval was 0.649-0.847,P< 0.05,the average area under the CSF-Glu/Blood-Glu ROC curve was 0.627,and the 95% confidence interval was 0.517-0.739,P< 0.05.Conclusion: The changes of blood glucose and CSF glucose,the MFS score of admission have significant influence on the death of aSAH patients,the condition of admission,the prognosis of CVS,and have good predictive ability and clinical significance.It provides a new way of diagnosis and treatment for clinicians.