摘要
目的探讨联合检测空腹血糖（fasting plasma glucose，FPG）、糖化血红蛋白（glycosylated hemoglobin A1C，HbA1c）及乳酸脱氢酶（1actate dehydrogenass，LDH）在重症颅脑外伤急性期患者病情评估及预后判断中的价值。方法52例重症颅脑损伤患者，分别依据人院时格拉斯哥昏迷评分（GlasgowComaScale，GCS）、FPG联合HbAtc检测情况及GCS预后评分进行分组，比较重度颅脑损伤组（GCS评分6～8分）与极重度颅脑损伤组（GCS评分3～5分）、糖尿病高血糖组（FPG〉6．1mmol／L且HbAlc〉6．2％）与应激性高血糖组（FPG〉6．1mmol／L且HbAlc〈6．2％）及不同预后患者LDH、FPG水平，并分析GCS评分与LDH、FPG的相关性。结果极重度颅脑损伤组FPG、LDH水平高于重度颅脑损伤组（P〈O．01）；糖尿病高血糖组与应激性高血糖组FPG、LDH水平及预后比较差异无统计学意义（P〉0．05）；恢复良好组、预后差组、死亡组LDH、FPG水平比较差异均有统计学意义（P〈0．01）；重症颅脑外伤患者人院时GCS评分与LDH、FPG水平呈负相关（r=-0．948，P=0．001；r=-0．941，P=0．001）。结论FPG、LDH可用于评估颅脑损伤严重程度，判断患者预后，HbA，c在鉴别诊断糖尿病性或应激性血糖增高中有重要价值。
Objective To evaluate the application value of combined detection of fasting plasma glucose （FPG） glycosylated hemoglobin （HbAlc） and lactate dehydrogenase （LDH） to evaluating the disease severity and prognosis in patients with acute severe craniocerebral trauma. Methods According to Glasgow Coma Scale （GCS） scores at admission, the levels of FPG and HbAlc, and the GCS prognosis scores, 52 patients with acute severe craniocerebral trauma were divided into severe craniocerebral trauma group （GCS： 6 to 8）, extremely severe craniocerebral trauma group （GCS： 3 to 5）, diabetic hyperglycosemia group （FPG〉 6. 1 mmol/L, HbAlc 〉 6. 2 %）, stress hyperglycemia group （FPG〉6.1 mmol/L, HbALc〈6.2%）, good recovery group, bad recovery group and death group, to compare the levels of LDH and FPG and analyze the correlation of GCS scores with LDH and FPG levels. Results The levels of FPG and LDH were higher in extremely severe craniocerebral trauma group than those in severe craniocerebral trauma group （P〈 0.01）. The levels of FPG and LDH showed significant differences in good recovery group, bad recovery group and death group （P 〈（0.01）, and showed no significant differences between diabetic hyperglycosemia group and stress hyperglycemia group （P〉0.05）. GCS score at admission was negatively correlated with the levels of LDH and FPG （r=-0. 948, P=0. 001; r=-0. 941, P=0. 001）. Conclusions The levels of FPG and LDH can be adopted to evaluate the severity of craniocerebral trauma and assess the prognosis, and the level of HbAlc plays an important role in the differential diagnosis of diabetes mellitus from stress hyperglycemia.
出处
《中华实用诊断与治疗杂志》
2014年第3期293-295,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
重症颅脑外伤
空腹血糖
糖化血红蛋白
乳酸脱氢酶
Severe craniocerebral trauma
fasting plasma glucose
glycosylated hemoglobin
lactate dehydrogenase
