【摘要】 目的 探讨高血糖对急性出血性卒中早期预后的影响。 方法 连续纳入发病72h内入院的急性出血性卒中患者105例,入院时评定美国国立卫生研究院卒中量表(NIHSS)评分并检测随机静脉血清葡萄糖，发病30d时进行改良Rankin量表评分(mRS)。采用多因素Logistic回归分析影响急性出血性卒中患者血糖水平的因素及高血糖对急性出血性卒中早期预后的影响。 结果 (1)入选的105例急性出血性卒中患者中，61例(58.1%)出现高血糖，年龄、DM史、感染、NIHSS评分是急性出血性卒中合并高血糖的危险因素(P<0.05)，DM史、NIHSS评分是急性出血性卒中合并高血糖的独立危险因素(P<0.05)。(2)感染、高血糖、NIHSS评分对mRS评分的影响有统计学差异(P<0.01)，高血糖、NIHSS评分是急性出血性卒中预后不良的独立危险因素(P<0.05)。 结论 急性出血性卒中合并高血糖是反映急性出血性卒中病情较重的指标之一，高血糖是急性出血性卒中早期预后不良的独立危险因素。

　　【关键词】高血糖;卒中;出血性;预后

　　Influence of hyperglycemia on the prognosis of patients with acute hemorrhagic stroke in early stage LI Zuo-jun, ZHONG Li-yong, QI Wen-wen, et al. Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

　　Corresponding author: ZHONG Li-yong, E-mail: zhongliyong@126.com

　　【Abstract】 Objective To investigate the influence of hyperglycemia on the prognosis of patients with acute hemorrhagic stroke in early stage. Methods In a consecutive way, 105 patients with acute hemorrhagic stroke (<72 hours) were enrolled in this prospective study. The scores of National Institutes of Health Stroke Scale (NIHSS) were calculated and the random serum glucose concentrations when they were admitted to hospital were tested, and the scores of Modified Rankin Scales (mRS) were evaluated 30 days after stroke. The multivariate stepwise Logistic regression analyses on the factors which affected the glycemia level and the influence of hyperglycemia on the prognosis of patients were carried out for investigation. Results (1). Of the 105 patients, 61 (58.1%) presented hyperglycemia at admission. Age, history of diabetes mellitus, infection, and NIHSS score were risk factors for acute hemorrhagic stroke patients accompanied with hyperglycemia (P<0.05). History of diabetes mellitus and NIHSS score were independent risk factors for acute hemorrhagic stroke patients accompanied with hyperglycemia (P<0.05). (2). The influence of infection, hyperglycemia, and NIHSS score on the score of mRS were statistically significant (P<0.01), and hyperglycemia and NIHSS score were independent risk factors for poor prognosis (P<0.05). Conclusion Hyperglycemia in the acute stage of hemorrhagic stroke predicates a serious degree of stroke. Hyperglycemia is an independent risk factor for poorer outcome in patients with acute hemorrhagic stroke in early stage.

　　【Key words】Hyperglycemia; Stroke; Hemorrhage; Prognosis