The Study Of The Relationship Between Impaired Glucose Tolerance And Ischemic Stroke (Meridian-apoplexyl)

ObjectiveTo analyz the relationship between impaired glucose tolerance in Ischemic Stroke(meridian-apoplexy),to observe the proportion of impaired glucose tolerance in patients with ischemic stroke,to study the state of origin-based distribution of the characteristics of TCM in ischemic stroke in patients with impaired glucose tolerance,to assess the risk of disease and severity of the condition of relevance in impaired glucose tolerance in patients with ischemic stroke,and to seek the objective bases of syndrome differentiation-tying in TCM of Ischemic Stroke and impaired glucose tolerance,so as to try to find guidances on the practice,of diagnosis and treatment based on overall analysis of the illness and the patient.Methods117cases of patients with Ischemic Stroke(meridian-apoplexy), admitted to the Foshan Hospital of TCM from May 2008 to March 2009,confirmed by CT or MRI were analyzed.Patients were classified in to five groups according to the measuring scale of dialectical diagnostic code about stroke:Liver-yang excessive rising group,Wind-phlegm with congestion emphraxis meridian,Phlegm-heat with blocked intestines,Qi differency with blood-stasis group,In deficiency and wind act group.We scored the neurological impairment.According to the results of the neurological impairment,the objects were divided into mild group,moderate group and severe group.And we measured intima-media thickness in 24 hours。When two weeks(for expelling irritability high blood sugar)patients All the patients were taken venous blood for oral glucose tolerance test(OGTT).The patient with diabetes don't need oral glucose tolerance test.According to the resultsof OGTT,the objects were divided into NGT group,IGT group and type 2 DM group.Results1.The orders of impaired glucose tolerance expression of patients of Ischemic Stroke(meridian-apoplexy) in different groups from top to low are Wind-phlegm with congestion emphraxis meridian group,Phlegm-heat with blocked intestines group,Qi difficency with blood-stasis group,Yin Deficiency and wind act group and Liver-yang excessive rising group;The TCM syndrome of impaired glucose tolerance,diabetes,normal blood sugar was no significant frequency;glucose TCM syndrome in each group no significant frequency(P>0.05);2.The rate of sugar metabolize abnormity in Ischemic Stroke (meridian-apoplexy) is 62.39%.The rate of impaired glucose tolerance is 29.91%.The rate of newly diagnosed impaired glucose tolerance is 62.86 %,while the rate of newly diagnosed 2-type diabetes is 26.32%;Diabetes and impaired glucose tolerance distribution of the frequency distribution of newly diagnosed difference was significant(P<0.01);3.Compared with the groups with NGT,intima—media thickness are significantly diferent in the groups with 2—type diabetes and the group with IGT group,(P<0.05).But the difference of intima—media thickness is not statistically significant between patients with IGT and diabetes mellitus;4.The blood sugar expression of the Ischemic Stroke patients with severe,moderate and mild had an decreasing tendency.In the comparison between every two groups,the levels of blood sugar expression in moderate patients are significantly lower than that of mild patients(P<0.05).The NIHSS scores is used to evaluated the severity of cerebral infarctio in Ischemic Stroke(merdian-apoplexy).Compared with the groups with NGT,the NIHSS scores are significantly diferent in the groups with 2-type diabetes and the group with IGT group,(P<0.05).But the difference of scores of NIHSS between IGT and diabetics is not statistically significant.Conclusions1.There is no relation between the origin and distribution of TCM syndrome in Ischemic stroke(meridian-apoplexy) in patients and impaired glucose tolerance,possibly because of stroke etiology and pathogenesis of complex diseases diversified,with a wide variety of pathogenic factors;2.Ischemic stroke in patients with impaired glucose tolerance combined state of origin and distribution of TCM syndrome with diabetes and normal blood sugar without significant difference in both,possibly because of stroke etiology and pathogenesis of complex diseases diversified,with a wide variety of pathogenic factors;3.It shows that the change of atherosclerosis might have started since early IGT stage.Impaired glucose tolerance,may affect intima—media thickness to increase the morbidity of acute Ischemic Stroke.It provides that Impaired glucose tolerance may be an Independent Risk factor of Stroke;4.The contents of 2 hours blood sugar can be rgarded as the essences in forecasting neurological impairment of people with IS。IGT has poor influence on the severity of cerebral infraction.Monitoring and correcting IGT may be a good measure of improving the progn osis of cerebral infarction.