Effect of individualized glycemic management on the prognosis of patients with severe cerebral hemorrhage

doi:10.3969/j.issn.1006-7795.2013.04.024

Abstract

Abstract:

Objective To evaluate the effect of individualized glycemic management on the prognosis of patients with severe cerebral hemorrhage. Methods Four hundred and fifty-one patients with severe cerebral hemorrhage(GCS score≤8) were randomly divided into two groups, to receive intensive insulin therapy or conventional insulin therapy. The mortality was observed in the 30th day after treatment. Results No significant difference in the mortality was found between the intensive insulin therapy group and conventional insulin therapy group(P>0.05). In 226 patients receiving intensive insulin treatment, a higher mortality was observed in patients with higher GHb(57.14% vs 40.63%, P=0.01). In 225 patients receiving conventional insulin treatment, a higher mortality was found in patients with normal GHb(49.65% vs 27.38%, P=0.001). Conclusion GHb should be tested in the patients with severe cerebral hemorrhage at admission, to provide information for adopting individualized glycemic management and setting glycemic control targets.

Key words: severe cerebral hemorrhage, glycemia, insulin, prognosis

CLC Number:

R743.34

REN Tianhua, SHI Hongmei. Effect of individualized glycemic management on the prognosis of patients with severe cerebral hemorrhage[J]. Journal of Capital Medical University, 2013, 34(4): 601-604.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2013.04.024

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2013/V34/I4/601

References

[1] Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients[J]. N Engl J Med, 2001,345(19):1359-1367.

[2] 崔乃杰.脓毒症多器官功能障碍综合征治疗进展[J].中华急诊医学杂志,2003,12(1):67-68.

[3] 韩璐,马涛,故文全,等.脓毒症的点胶损伤[J].中国煤炭工业医学杂志,2012,15(6):890-892

[4] Esposito K, Nappo F, Marfella R, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress[J]. Circulation, 2002,106(16):2067-2072.

[5] 王涛,李春盛.危重病患者血脑变化及其对预后的影响[J].中国医科大学学报,2011,40(6):843-847.

[6] The NICE-SUGAR Study Investigators. Intensive versus conventional glucose control in critically ill patients[J]. N Engl J Med, 2009,360(13):1283-1297.

[7] Griesdale D E, de Souza R J, van Dam R M, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data[J]. CMAJ, 2009,180(8):821-827.

[8] Krinsley J S. Glycemic control, diabetic status and mortality in a heterogeneous population of critically ill patients before and during the era of intensive glycemic management: six and one-half years experience at a university-affiliated community hospital[J]. Semin Thorac Cardiovasc Surg, 2006,18(4):317-325.

[9] Egi M, Bellomo R, Stachowski E, et al. Blood glucose concentration and outcome of critical illness: the impact of diabetes[J]. Crit Care Med, 2008,36(3):2249-2255.

[10] 胡耀敏,刘伟,陈雅文,等.内科重疗监护病房住院患者926例高血糖临床资料分析-上海仁济医院2002至2009年资料回顾[J].中华内分泌代谢杂,2010,26(5):448-451.

[11] Dungan K M, Braithwaite S S, Preiser J C. Stress hyperglycaemia[J]. Lancet, 2009,373(9677):1798-1807.

[12] Moghissi E S, Korytkowski M T, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus on inpatient glycemic contro1[J]. Diabetes Care, 2009,32(6):1119-1131.

[13] 杨文英.重视颅防,规范管理-2007年版《中国2型糖尿病防治指南》[J].中华内分泌代谢杂志,2008,24(2):121-122.

[14] International Expert Committee. International Expert Committee report on the role of the AIC assay in the diagnosis of diabetes[J]. Diabetes Care, 2009,32(suppl 2):1327-1334.

[1]	Wang Rongrong, Tian Junping. Correlation between serum calcium and cardiovascular outcome in patients with acute coronary syndrome [J]. Journal of Capital Medical University, 2023, 44(1): 154-160.
[2]	Jia Jing, Chen Wenming, Li Yanchen. Clinical characteristics and prognostic analysis of multiple myeloma involving central nervous system [J]. Journal of Capital Medical University, 2023, 44(1): 161-166.
[3]	Yu Tianyu, Jiang Shimin, Gao Hongmei, Zou Guming, Li Wenge. Clinical and pathological risk factors for renal prognosis in patients with biopsy-proven diabetic nephropathy classified as chronic kidney disease stage 4 [J]. Journal of Capital Medical University, 2022, 43(5): 707-712.
[4]	Gu Qiang, Yu Xiaojun, Zhang Jin. Analysis of clinical characteristics and prognosis of the very old and young old patients with mild ischemic stroke [J]. Journal of Capital Medical University, 2022, 43(3): 474-479.
[5]	Zhou Qiaoyun, Huang Xiaowu, Xia Enlan, Zhao Yuting, Huang Rui. Reproductive outcomes of women treated for intrauterine adhesions following uterine artery embolization [J]. Journal of Capital Medical University, 2022, 43(3): 490-494.
[6]	Miao Zupei, Zhang Yinghua, Xiao Keling, Si Jin, Zhang Haoyu, Li Jing. Influence of obesity on the prognosis of patients with STEMI [J]. Journal of Capital Medical University, 2022, 43(2): 192-198.
[7]	Sun Jing, Shi Youwu, Jia Jun, Yang Ying, Sun Zhiwei, Du Feng, Yu Jing, Xiao Yanjie, Zhang Xiaodong. Prognostic value of peripheral blood inflammation-based markers in metastatic pancreatic cancer [J]. Journal of Capital Medical University, 2022, 43(2): 299-304.
[8]	Liu Yang, Wu Yumei, He Yue, Fan Bei, Wang Yan, Zhao Hui, Wang Ming. Rationality verification and evaluate of the 2018 International Federation of Gynecology and Obstetrics staging system for stage ⅠB cervical cancer [J]. Journal of Capital Medical University, 2021, 42(6): 1026-1032.
[9]	Wang Li, Zhang Guojun. Study on the application value of serum neuron-specific enolase in diagnosis and therapeutic effect on patients with traumatic brain injury [J]. Journal of Capital Medical University, 2021, 42(5): 715-720.
[10]	Zhang Dongxue, Wen Zhen, Sun Yuyan, Jiang Tao. Association between hepatic insulin clearance,clinical characteristics and gut hormone in Chinese patients with newly diagnosed type 2 diabetes mellitus [J]. Journal of Capital Medical University, 2021, 42(5): 822-828.
[11]	Lai Xuan, Zhang Aihua. Effect of metabolic syndrome on survival outcome of chronic kidney disease [J]. Journal of Capital Medical University, 2021, 42(4): 609-614.
[12]	Wang Jingshang, Yin Xiaodan, He Junqin, Wu Ying, Zhang Ying, Li Xianrui. Experimental study on establishment of polycystic ovary syndrome rat model with insulin resistance by letrozole combined with high-sugar and high-fat diet [J]. Journal of Capital Medical University, 2021, 42(3): 436-442.
[13]	Wang Xin, Zhang Junxuan, Gao Jian, Shi Hanping. Immunonutrition improves the prognosis of patients with cancer [J]. Journal of Capital Medical University, 2020, 41(6): 1019-1024.
[14]	Liu Jun, Cao Qingfei, Ye Xiongjun, Chen Weinan, Zhao Haiyue, Tong Ming, Wang Yinyin, Huang Xiaobo, Chang Zhijie. Relationship between CREPT expression and prognosis in renal cell carcinoma [J]. Journal of Capital Medical University, 2020, 41(4): 552-557.
[15]	Wu Xikang, Wang Yue, He Huiying. Expression and significance of Slit guidance ligand 3 in upper tract urothelial carcinoma [J]. Journal of Capital Medical University, 2020, 41(3): 354-359.