目的：观察血糖水平及血糖漂移对2型糖尿病(type 2 diabetes mellitus，T2DM)合并急性脑梗死(acute cerebral infarction，ACI)患者神经功能缺损的影响。方法：选取2014年3月至2015年6月在我院治疗的ACI患者作为观察对象，根据其是否合并2型糖尿病史，将其分为2组：合并2型糖尿病组(DMCI组，42例)和不合并2型糖尿病组(NDMCI组，45例)。比较两组患者平均血糖水平(mean blood glucose，MBG)、血糖水平标准差(standard deviation of blood glucose，SDBG)、血糖波动频数(number of effective glucose excursions，NEGE)、最大血糖波动幅度(largest amplitude of glycemic excursions，LAGE)以及平均血糖波动幅度(mean amplitude of glycemic excursions，MAGE)的差异；观察两组患者神经功能缺损评分的差异，分析血糖水平及血糖漂移与神经功能缺损的相关性。结果：DMCI组患者神经功能缺损评分(National Institutes of Health Stroke Scale，NIHSS)明显高于NDMCI组，差异具有统计学意义(P<0.05)；DMCI组患者MBG、SDBG、NEGE、LAGE和MAGE水平均明显高于NDMCI组，差异具有统计学意义(P<0.05)；NIHSS评分与MBG、SDBG、NEGE、LAGE和MAGE水平均明显正相关(r=0.356、0.412、0.389、0.435和0.397，P<0.05)。结论：血糖及血糖漂移的高水平可加重T2DM合并ACI患者的神经功能缺损程度。
Effect of blood glucose level and blood glucose excursion on the neurological deficits in patients with type 2 diabetes mellitus and acute cerebral infarction
Objective: To observe the effect of blood glucose level and blood glucose excursion on the neurological deficits of type 2 diabetes mellitus (T2DM) patients with acute cerebral infarction (ACI). Methods: ACI patients treated in our hospital from March 2014 to June 2015 were selected as observation objects, according to whether the merger history of type 2 diabetes, the patients were divided into two groups: combined with type 2 diabetes mellitus group (DMCI group, 42 cases) and associated with type 2 diabetes mellitus group (NDMCI group, 45 cases). Compared the mean blood glucose (MBG), standard deviation of blood glucose (SDBG), number of effective glucose excursions (NEGE), largest amplitude of glycemic excursions (LAGE), and mean amplitude of glycemic excursions (MAGE) of the two groups. The difference of nerve function defect score between two groups were observed, and the correlation between blood glucose level and blood glucose excursion and nerve function defect were analyzed. Results: The NIHSS score of DMCI group was significantly higher than that of NDMCI group, and the difference was statistically different (P<0.05); the level of MBG, SDBG, NEGE, LAGE and MAGE in group DMCI were significantly higher than those of NDMCI group, the difference was statistically different (P<0.05); NIHSS scores was significantly positively correlated with MBG, SDBG, NEGE, LAGE and MAGE level (r=0.356, 0.412, 0.389, 0.435 and 0.397, P<0.05). Conclusion: The high level of blood glucose and glucose excursion can aggravate the degree of neurological deficits in patients with T2DM and ACI.