Clinical Study Of Abnormal Glucose Metabolism In Patients With Acute Cerebral Infarction

Objectives To explore the consistency of fasting blood glucose(FPG),2 hour oral glucose tolerance test(2h OGTT)and glycated hemoglobin(Hb A1c),and to explore the correlation between abnormal glucose metabolism and prognosis in patients with cerebral infarction.Methods Through sharing with the data of Beijing Tiantan Hospital affiliated to Capital Medical University,this study reviewed the retrospective analysis of 1251 patients who had been admitted to the Department of Neurology for acute cerebral infarction from August 8,2008 to 1 by 35 medical institutions in China,who had no history of diabetes and were hospitalized with blood glucose < 11.1mmol/L in 1 days from August 8,2008 to June 2010.By collecting the baseline data,blood sugar data and follow-up data,1251 patients were analyzed statistically.According to the blood glucose level,the subjects were divided into three layers of normal blood sugar,prediabetes and first diagnosed diabetes.The Hb A1 c positive results were the gold standard.The sensitivity and specificity of FPG and 2h OGTT were compared,and the ROC curves were established,and the area(AUC)and the Jordan index under the ROC curve were calculated.(Youden 's index)was used to analyze the consistency of the three blood glucose detection indexes,and the multiple factor analysis was carried out by logistics regression to explore the correlation between abnormal glucose metabolism and the prognosis of cerebral infarction.Results 1 Among the 1251 subjects,789(63.3%)were males.In combination with the results of three blood glucose indicators,241 cases of normal blood glucose(19.4%),the average age of 58.3±12.6 years,471 cases(19.4%)in pre diabetes(19.4%),the average age of 61.8±12.8,539 cases(43.1%)of first diagnosed diabetes,average age of 64.2 ±11.9 years.2 the average age of prediabetes was higher than that of normal blood glucose group,P=0.001,the difference was statistically significant(P<0.05);low density lipoprotein,hyperlipidemia,atrial fibrillation history and TOAST typing were statistically significant(P=0.03,P=0.01,P=0.03)at admission(P < 0.05);in hospital period,the difference was statistically significant(P < 0.05).The difference was statistically significant(P=0.02,P=0.02)between antihypertensive drugs,statins,and pulmonary infection(P=0.032).The difference was statistically significant(P< 0.05).8 the OR(95%CI)values of poor prognosis at 14 days,3 months and 1 years after the onset of first diagnosed diabetes were 1.55(1.01-2.40),2.49(1.58-3.93),2.97(1.87-4.74),and the risk of poor prognosis was 0.55,1.49 and 1.97 times respectively.Conclusions 1 Fasting blood glucose(FPG),2 hour oral glucose tolerance test(2h OGTT)and glycated hemoglobin(Hb A1c)were consistent with three kinds of blood sugar detection indexes.The combination of multiple blood glucose detection indexes could reduce abnormal leakage rate of glucose metabolism,early detection and early adoption of blood glucose intervention measures.2 with the increase of abnormal glucose metabolism,the worse the prognosis of cerebral infarction and the increase of adverse risk of prognosis.First diagnosis of diabetes is an independent risk factor affecting the prognosis of cerebral infarction.