中国卒中杂志2012，Vol.7Issue(5)：376-381,6.
609例缺血性卒中住院患者糖调节异常的横断面研究
Cross Sectional Research on Abnormal Glucose Regulation in 609 Inpatients with First-Ever Ischemic Stroke
摘要
Abstract
Objective To investigate the state of abnormal glucose regulation(AGR) in 609 inpatients with the first-ever ischemic stroke(FIS). To comprehend the importance of oral glucose tolerance test(OGTT) in the diagnosis of AGR. Methods Inpatients with F1S were enrolled consistently into our study from Aug. 2008 to Nov. 2009, who were hospitalized in Neurology Department of Beijing Tiantan Hospital. A total of 609 inpatients with F1S were included in the study. Age, sex, history of diabetes mellirus(DM), blood pressure, biochemical indicators, the score of National Institute of Health Stroke ScalefNIHSS) and Glasgow Coma Scale(GCS) were recorded. After 14? days of the patients' onsets, an oral glucose tolerance test(OGTT) would be performed to characterize the glucose metabolism status of the inpatients with FIS. The difference was compared in the diagnosis of AGR with the standard of fasting plasma glucose(FPG) and OGTT. A kappa test was done in the two diagnostic criteria of AGR and found the difference between them. Results Among 609 inpatients with FIS, the total numbers of inpatients with history of DM were 120 cases, but there were 143 cases of newly diagnosed of DM, 137 cases of newly diagnosed of impaired glucose regulation(lGR), so the general prevalence of AGR was 65.7%. The prevalence of DM and IGR was 43.2% and 22.5% respectively. In total, 122 cases of IGR and 95 cases of DM were undiagnosed. If FPG was detected alone, 89.1% IGR and 66.4% newly diagnosed DM would have remained undiagnosed. Considered the criteria of OGTT about AGR as gold standard, a kappa test was done in the diagnostic criteria of FPG compared with that of OGTT, the value of kappa test was 0.226, P>0.05, it had statistically significance and indicated that the concordance of the two diagnostic standards was not good. Conclusion Most of inpatients with FIS have AGR in Beijing, but if the FPG was tested only, many inpatients who had AGR would be underdiagnosed, so it was very important to screen them by OGTT. The standard of OGTT couldn't be replaced by the criteria of FPG on the diagnosis of AGR.关键词
缺血性卒中/葡萄糖,调节/患病率Key words
Ischemic stroke/ Glucose, regulation/ Prevalence引用本文复制引用
刘新琼,李艳华,王春雪,郑华光,贾茜,王献伟,王拥军..609例缺血性卒中住院患者糖调节异常的横断面研究[J].中国卒中杂志,2012,7(5):376-381,6.基金项目
国家自然科学基金(81071115) （81071115）
市自然科学基金(7102050) （7102050）
北京市卫生局高层次人才资助项目(2011-3-023) （2011-3-023）
