血糖控制水平与急性缺血性脑卒中预后关系的最新研究进展
Recent Research Advances on the Relationship between Glycemic Control Level and the Prognosis of Acute Ischemic Stroke
摘要: 缺血性脑卒中是一种脑血管疾病,由脑血管病变引起脑组织缺血而产生。该疾病的发展过程中伴随大量细胞凋亡,导致高致残率和病死率。血糖控制在治疗和管理缺血性脑卒中中起着重要作用。保持血糖水平良好可以改善患者的预后,因为高血糖水平可能导致血管损伤、炎症反应和氧化应激等不良生理反应,进一步加剧脑组织缺血的损伤。调整血糖浓度,有助于降低各种副作用,推动脑部结构的重建与功能的提升,因此降低了死亡率和残障率,也改善了缺血性脑卒中病人的治疗效果。本文综述了近年来关于血糖控制水平对糖尿病合并缺血性脑卒中患者预后影响的相关研究。
Abstract: Ischemic stroke is a cerebrovascular disease, caused by cerebral tissue ischemia caused by cere-brovascular disease. The development of the disease is accompanied by massive cell apoptosis, re-sulting in high disability and case fatality rates. Glycemic control plays an important role in the treatment and management of ischemic stroke. Maintaining a good blood glucose level can improve the prognosis of patients, because high blood glucose levels may lead to adverse physiological reac-tions such as vascular damage, inflammatory response and oxidative stress, further aggravating the damage of brain tissue ischemia. Adjusting blood glucose concentration can help reduce various side effects, and promote the reconstruction of brain structure and function, thus reducing the mortality and disability rate, and improving the treatment effect of ischemic stroke patients. This review summarizes recent studies on the impact of glycemic control levels on the prognosis of dia-betic patients with ischemic stroke.
文章引用:艾拉古丽·伊米提, 伊力哈木江·依马木, 李珊珊. 血糖控制水平与急性缺血性脑卒中预后关系的最新研究进展[J]. 临床医学进展, 2023, 13(12): 20098-20103. https://doi.org/10.12677/ACM.2023.13122829

参考文献

[1] Martinez, M., Santamarina, J., Pavesi, A., et al. (2021) Glycemic Variability and Cardiovascular Disease in Patients with Type 2 Diabetes. BMJ Open Diabetes Research & Care, 9, e002032. [Google Scholar] [CrossRef] [PubMed]
[2] Shi, H., Gw, Y.S., Wang, H.M., et al. (2021) Fasting Blood Glucose and Risks of Stroke: A Dose-Response Meta-Analysis. Clinical Nutrition, 40, 3296-3304. [Google Scholar] [CrossRef] [PubMed]
[3] Wang, Y., Zhu, L., Tan, X., et al. (2022) Higher Levels of Periph-eral Blood Glucose in the Actue Stage of Stroke Increase the Risk of Post-Stroke Depression: A Sysematic Review and Meta-Analysis. Neuroscience & Biobehavioral Reviews, 142, Article ID: 104829. [Google Scholar] [CrossRef] [PubMed]
[4] 杨倩, 刘祚燕, 王凤英. 老年老年糖尿病合并脑卒中患者血糖水平与神经功能恢复的相关性分析[J]. 老年医学与保健, 2021, 27(2): 405-408
[5] Emerging Risk Factors Collaboration, Sarwar, N., Gao, P., et al. (2010) Diabetes Mellitus, Fasting Blood Glucose Concentration, and Risk of Vascular Disease: A Collaborative Meta-Analysis of 102 Prospective Studies. The Lancet, 375, 2215-2222. [Google Scholar] [CrossRef
[6] Georgakis, M.K., Harshfied, E.L., Malik, R., Franceschini, N., Langenberg, C., Wareham, N.J., Markus, H.S. and Dichgans, M. (2021) Diabetes Mellitus, Glycemic Traits, and Cerebrovascular Disease: A Mendelian Randomization Study. Neurology, 96, e1732-e1742.
[7] Palaiodimou, L., Liou-tas, V.A., Lambadiar, V., et al. (2021) Glycemicvariability of Acute Stroke Patients and Clinical Outcomes: A Continu-ous Glucose Monitoring Study. Therapeutic Advances in Neurological Disorders, 14, 1-13. [Google Scholar] [CrossRef] [PubMed]
[8] 朱婧, 罗彩凤, 倪益益, 等. 2型糖尿病病人并发缺血性脑卒中急性期血糖波动趋势及影响因素分析[J]. 安徽医药, 2019, 23(12): 2395-2399.
[9] Bril, F., Mcphaul, M.J., Caulfield, M.P., et al. (2019) Performance of the SteatoTest, ActiTest, NashTest and FibroTest in a Multiethnic Cohort of Patients with Type 2 Diabetes Mellitus. Journal of Investigative Medicine, 67, 303-311. [Google Scholar] [CrossRef] [PubMed]
[10] 黄金鑫, 吕肖锋, 李娟, 等. 2型糖尿病合并急性脑梗死患者入院早期血糖波动及其临床意义[J]. 中国糖尿病杂志, 2014, 22(3): 200-203.
[11] Kim, Y.S., Kim, C., Jung, K.H., et al. (2017) Range of Glucose as a Glycemic Variability and 3-Month Outcome Indiabet Patients with Actue Ischemic Stroke. PLOS ONE, 12, e0183894. [Google Scholar] [CrossRef] [PubMed]
[12] Huang, J.X., Zhang, X.G., Li, J., et al. (2014) Impact of Glucose Fluctuation on Acute Cerebral Infarction in Type 2 Diabetes. Canadian Journal of Neurological Sciences, 41, 486-492. [Google Scholar] [CrossRef
[13] Saposnik, G., Fang, J., Kapral, M.K., Tu, J.V., Mamdani, M., Austin, P., et al. (2012) The iScore Predicts Effectiveness of Thrombolytic Ther-apy for Acute Ischemic Stroke. Stroke, 43, 1315-1322. [Google Scholar] [CrossRef
[14] Heldner, M.R., Zubler, C., Mattle, H.P., Schroth, G., Weck, A., Mono, M.L., et al. (2013) National Institutes of Health Stroke Scale Score and Vessel Occlusion in 2152 Pa-tients with Acute Ischemic Stroke. Stroke, 44, 1153-1157. [Google Scholar] [CrossRef
[15] Jia, Q., Zhao, X., Wang, C., Wang, Y., Yan, Y., Li, H., et al. (2011) Diabetes and Poor Outcomes within 6 Months after Acute Ischemic Stroke: The China National Stroke Regis-try. Stroke, 42, 2758-2762. [Google Scholar] [CrossRef
[16] Ormstad, H., Aass, H.C., Amthor, K.F., Lund-Sørensen, N. and Sandvik, L. (2012) Serum Levels of Cytokines, Glucose, and Hemoglobin as Possible Predictors of Poststroke Depression, and Association with Poststroke Fatigue. International Journal of Neuroscience, 122, 682-690. [Google Scholar] [CrossRef] [PubMed]
[17] Kruyt, N.D., van Westerloo, D.J. and DeVries, J.H. (2012) Stress-Induced Hyperglycemia in Healthy Bungee Jumpers without Diabetes Due to Decreased Pancreatic β-Cell Func-tion and Increased Insulin Resistance. Diabetes Technology & Therapeutics, 14, 311-314. [Google Scholar] [CrossRef] [PubMed]
[18] Yu, K.H., Hong, K.S., Lee, B.C., Oh, M.S., Cho, Y.J., Koo, J.S., et al. (2011) Comparison of 90-Day Case-Fatality after Ischemic Stroke between Two Different Stroke Outcome Registries Using Propensity Score Matching Analysis. Acta Neurologica Scandinavica, 123, 325-331. [Google Scholar] [CrossRef] [PubMed]
[19] Chen, R.L., Balami, J.S., Esiri, M.M., Chen, L.K. and Buchan, A.M. (2010) Ischemic Stroke in the Elderly: An Overview of Evidence. Nature Reviews Neurology, 6, 256-265. [Google Scholar] [CrossRef] [PubMed]
[20] Shimoyama, T., Kimura, K., Uemura, J., Saji, N. and Shibazaki, K. (2014) Elevated Glucose Level Adversely Affects Infarct Volume Growth and Neurological Deterioration in Non-Diabetic Stroke Patients, But Not Diabetic Stroke Patients. European Journal of Neurology, 21, 402-410. [Google Scholar] [CrossRef] [PubMed]
[21] Bellolio, M.F., Gilmore, R.M. and Ganti, L. (2014) Insulin for Glycaemic Control in Acute Ischaemic Stroke. Cochrane Database of Systematic Reviews, 1, CD005346. [Google Scholar] [CrossRef
[22] Bahader, G.A., Nash, K.M., Almarghalani, D.A., et al. (2021) Type-I Diabetes Aggravates Post-Hemorrhagic Stroke Cognitive Impairment by Augmenting Oxidative Stress and Neuroinflammation in Mice. Neurochemistry International, 149, Article ID: 105151. [Google Scholar] [CrossRef] [PubMed]
[23] Orasanu, G. and Plutzky, J. (2009) The Continuum of Diabetic Vascular Disease: From Macro- to Micro. Journal of the American College of Cardiology, 53, S35-S42.
[24] Zhou, J.W., Wu, J.H., Zhang, J.T., et al. (2015) Association of Stroke Clinical Outcomes with Coexistence of Hyperglycemia and Biomarkers of Inflammation. Journal of Stroke and Cerebrovascular Diseases, 24, 1250-1255. [Google Scholar] [CrossRef] [PubMed]
[25] Cai, R., Han, J., Sun, J., et al. (2016) Plasma Clusterin and the CLU Gene rs11136000 Variant Are Associated with Mild Cognitive Impairment in Type 2 Diabetic Pa-tients. Frontiers in Aging Neuroscience, 8, Article 179. [Google Scholar] [CrossRef] [PubMed]
[26] Polidori, M.C., Mecocci, P., Stahl, W., et al. (2000) Plasma Levels of Lipophilic Antioxidants in Very Old Patients with Type 2 Diabetes. Diabetes/Metabolism Research and Reviews, 16, 15-19. [Google Scholar] [CrossRef
[27] Ronchi, D., Palmer, K., Pioggiosi, P., et al. (2007) The Combined Effect of Age, Education, and Stroke on Dementia and Cognitive Impairment No Dementia in the Elderly. Dementia and Geriatric Cognitive Disorders, 24, 266-273. [Google Scholar] [CrossRef] [PubMed]
[28] Mackness, B., Hunt, R., Durrington, P.N. and Mackness, M.I. (1997) In-creased Immunolocalization of Paraoxonase, Clusterin, and Apolipoprotein A-I in the Human Artery Wall with the Pro-gression of Atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, 17, 1233-1238. [Google Scholar] [CrossRef
[29] Ahmad, W. (2013) Overlapped Metabolic and Therapeutic Links between Alzheimer and Diabetes. Molecular Neurobiology, 47, 399-424. [Google Scholar] [CrossRef] [PubMed]
[30] Albai, O., Frandes, M., Timar, R., Roman, D. and Timar, B. (2019) Risk Factors for Developing Dementia in Type 2 Diabetes Mellitus Patients with Mild Cognitive Impairment. Neuropsy-chiatric Disease and Treatment, 15, 167-175.