颅脑外伤急性期血糖、肌酐的变化与疾病转归的研究

PDF(489 KB)

联勤军事医学 ›› 2017, Vol. 31 ›› Issue (05) : 297-0.

临床研究

颅脑外伤急性期血糖、肌酐的变化与疾病转归的研究

李慧¹,周杰²

作者信息 +

文章历史 +

摘要

探讨颅脑外伤急性期血糖、肌酐的改变与病情转归的关系判断患者预后，指导临床提供理论依据。方法选取2014年10月～2015 年 10月来我院神经外科的71例颅脑外伤患者，按照病情计分法（格拉斯哥昏迷量表，GCS）将患者分为轻型组、中型组、重型组。观察不同时间点每组患者的血糖、肌酐的改变情况。结果颅脑外伤患者伤后血糖、肌酐均升高，重型组血糖、肌酐水平明显高于轻型组及中型组，具有显著统计学差异（p＜0.05）。轻型组患者伤后30d复查血糖、肌酐基本恢复正常，中型、重型组血糖升高持续时间长，伤后30d仍保持较高水平；中型组肌酐恢复正常，但重型组肌酐仍高于正常值。表明颅脑损伤GCS评分越低，血糖、肌酐值越高，持续时间越长。结论监测颅脑外伤患者的血糖、肌酐水平，对及时采取合理的治疗措施，提高此期颅脑外伤疾病救治成功率，指导临床工作。

Abstract

To investigate the relationship between the change of blood glucose and creatinine and the prognosis of patients with craniocerebral trauma, and to provide theoretical basis for guiding clinical prognosis. Methods 71 cases of patients with craniocerebral trauma from October 2014 to October 2015 were divided into mild group, moderate group and severe group according to the score of disease (Glasgow Coma Scale, GCS). The changes of blood glucose and creatinine were observed in each group at different time points. Results The levels of blood glucose and creatinine in the patients with severe traumatic brain injury were significantly higher than those in the light and medium groups (p <0.05). In the light group, blood glucose and creatinine returned to normal level 30 days after injury. The duration of blood glucose in medium and heavy group was longer than that in normal group. The level of creatinine in medium group was higher than that in normal group. Indicating that the lower the GCS score of craniocerebral injury, the higher the blood glucose, creatinine value, the longer the duration. Conclusion The monitoring of blood glucose and creatinine levels in patients with traumatic brain injury is of great significance in assessing prognosis and ly taking treatment measures to improve the success rate of treatment.

引用本文

EndNote

Ris (Procite)

Bibtex

导出引用

李慧蔡忠林梁仲珍马莉徐倩孙建军周杰. 颅脑外伤急性期血糖、肌酐的变化与疾病转归的研究[J]. 联勤军事医学, 2017, 31(05): 297-0

参考文献

[1]Hayes, R.L.; Jenkins, L.W.; Lyeth, B.G. Neurotrans brain injury: Acetylcholine and excitatory amino ac S173–S187.[J].Acetylcholine and excitatory amino ac, 1998, 24(8):S173-S187
[2]McIntosh, T.K.; Saatman, K.E.; Raghupathi, R.; GTrojanowski, J.Q. The dorothy russell memorial lectu experimental traumatic brain injury: Pathogenetic me1998, 24, 251–267.[J].Pathogenetic me, 1998, 24(5):251-267
[3]Van Beek JG, Mushkudiani NA, Steyerberg EW, Butcher I, McHugh GS, Lu J, Marmarou A, Murray GD, Maas AI: Prognostic value of admission laboratory parameters in traumatic braininjury: results from the IMPACT study.J Neurotrauma 2007, 24:315-328.[J].Neurotrauma, 2007, 24(4):315-328
[4]Jeremitsky E, Omert LA, Dunham CM, Wilberger J, Rodriguez A:The impact of hyperglycemia on patients with severe brain injury.J Trauma 2005, 58:47-50.[J].Trauma, 2005, 58(5):47-50
[5]Gale SC, Sicoutris C, Reilly PM, Schwab CW, Gracias VH:Poor glycemic control is associated with increased mortality in critically ill trauma patients.Am Surg 2007, 73:454-460.[J].Am Surg, 2007, 73(7):454-460
[6]Longstreth WT Jr, Inui TS: High blood glucose level on hospital admission and poor neurological recovery after cardiac arrest.Ann Neurol 1984, 15:59-63.[J].Ann Neurol, 1984, 15(7):59-63
[7]Capes SE, Hunt D, Malmberg K, Gerstein HC: Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview.Lancet 2000, 355:773-778.[J].Lancet, 2000, 355(11):773-778
[8]Kermer, P.; Kl?cker, N.; B?hr, M. Neuronal death after brain injury. Models, mechanisms, and therapeutic strategies in vivo. Cell Tissue Res. 1999, 298, 383–395.[J].Cell Tissue Res, 1999, 298(10):383-395
[9]Graham, D.I.; McIntosh, T.K.; Maxwell, W.L.; Nicoll, J.A. Recent advances in neurotrauma. J. Neuropathol. Exp. Neurol. 2000, 59, 641–651.[J].Exp. Neurol, 2000, 59(5):641-651
[10]Weaver, S.M.; Chau, A.; Portelli, J.N.; Grafman, J. Genetic polymorphisms influence recovery from traumatic brain injury. Neuroscientist 2012, 18, 631–644.[J].Neuroscientist, 2012, 18(4):631-644
[11] Dardiotis, E.; Grigoriadis, S.; Hadjigeorgiou, G.M. Genetic factors influencing outcome from neurotrauma. Curr. Opin. Psychiatry 2012, 25, 231–238.[J].Psychiatry, 2012, 25(5):231-238
[12] Dardiotis, E.; Fountas, K.N.; Dardioti, M.; Xiromerisiou, G.; Kapsalaki, E.; Tasiou, A.; Hadjigeorgiou, G.M. Genetic association studies in patients with traumatic brain injury.Neurosurg. Focus 2010, 28, E9.[J].Neurosurg. Focus, 2010, 28(4):E9-E12
[13]林丽珍，温桂林，霍维芝.脑外伤应激性高血糖动态变化与预后的关系[J].现代医院, 2011, 11(8):48-49
[14]刘志凡.颅脑损伤后内血糖值与伤情程度和预后的关系[J].检验医学与临床, 2011, 8(24):2991-2993
[15]彭远强，梁鉴添，温宝泉.老年急性颅脑损伤患者血糖、- 反应蛋白、血小板的动态变化及其临床意义[J].中国老年学杂志, 2013, 8(16):3835-3837
[16]罗运山，邓霞梅，李颖，等.反应蛋白、血糖水平动态变化与颅脑损伤病情和预后的关系[J].中国医学创新, 2014, 11(27):54-56
[17]张摇威，陈郁强，谢扬，等.颅脑外伤急性期血糖、反应蛋白的改变与神经系统功能损伤的相关研究[J].现代医院, 2014, 14(2):10-12
[18]陈伟平, 龚洪桂, 陈劲飞, 等.重型颅脑损伤并发急性肾功能衰竭 25 例病因及治疗体会[J].右江民族医学院学报, 2006, 4:580-581.[J].右江民族医学院学报, 2006, 4(2):580-581
[19] 刘冬云, 李静, 史宝海, 等.新生大鼠缺氧缺血性脑损伤后肾脏SOD、M DA 的变化[J], 2006, 21( 1): 24-25.[J].齐齐哈尔学报, 2006, 21(1):24-25
[20]Aronson D: Hyperglycemia and the pathobiology of diabetic complications.Adv Cardiol 2008, 45:1-16.[J].Adv Cardiol, 2008, 45(3):1-16
[21] Sperry JL, Frankel HL, Vanek SL, Nathens AB, Moore EE, Maier RV, Minei JP:Early hyperglycemia predicts multiple organ failure and mortality but not infection.J Trauma 2007, 63:487-493.[J].Trauma, 2007, 63(4):487-493

PDF(489 KB)

Accesses

Citation

Detail

段落导航

摘要
Abstract
引用本文
参考文献

收稿日期	修回日期	出版日期
2016-11-04	2017-04-17	2017-05-28
发布日期
2017-05-28

{{custom_sec.title}}

{{custom_sec.title}}

{{custom_fnGroup.title_cn}}

脚注

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

摘要

Abstract

引用本文

{{custom_sec.title}}

{{custom_sec.title}}

参考文献

{{custom_fnGroup.title_cn}}

脚注