Correlation Between Blood Glucose Level And Prognosis And Risk Of Intracerebral Hemorrhage After Intravenous Recombinant Tissue Plasminogen Activator Thrapy For Acute Ischemic Stroke

Objective: To investigate the effect of hyperglycaemia on the prognosis of acute cerebral infarction with treated with recombinant human tissue -type plasminogen activator,rt-PA, and the correlation between hypergly- caemia and hemorrhagic transformation.Methods: Retrospective analysis of 53 cases of clinical patients with insist on follow-up visit. National Institutes of Health Stroke Scale (NIHSS) of baseline 2-25 scores. And these patients have no cerebral hemorrhage with examination of cranial CT. This cases divided to two groups with interval between the onset and the treatment of rt-PA, group A (≤3h), group B((3～9h,screening with multimode CT). According to blood sugar level , A and B group divided into two subgroups, the group of hyperglycaemia(≥7.8mmol/L) and the group of normal blood sugar level(<7.8mmol/L). To analyze the NIHSS of baseline,24h,14d after thrombolysis, mRS after onset, mortality and hemorrhagic transformation rate.Results:1 group A have 31 cases, subgroup of hyperglycaemia 11cases, subgroup of normal blood sugar 20 cases; group B have 22 cases subgroup of hyperglycaemia 8cases,subgroup of normal blood sugar 14 cases;2 To compare subgroup in group A and B: ( 1) NIHSS of pretreatment of thrombolysis,24h after thrombolysis and 14d after thrombolysis have no statistical significance(P>0.05);NIHSS of baseline and 24h,14d have statistical significance(P<0.05). (2)Proportion of 90d mRS0～1 have no statistical significance(P>0.05);(3)The mortality have no statistical significance( P> 0.05) ,but the blood sugar level between the dead ((10.95±3.97mmol/L)and survival(8.04±3.45 mmol/L)have statistical significance(P<0.05). (4)hemorrhagic transformation rate. Have no statistical significance,but cases of symptomatic intracranial hemorrhage belong to subgroup of hyperglycaemia, symptomatic intracranial hemorrhage is cause of death. Subgroup of normal blood sugar have no symptomatic intracranial hemorrhage case.Conclusions: Compare with subgroup of normal blood sugar level, the subgroup of hyperglycaemia less benifite from thrombolysis. Hypergly- caemia have obvious correlation with mortality after thrombolysis. Hyperglycaemia have obvious correlation with hemorrhagic transformation.