血糖水平对糖尿病合并急性脑梗死患者预后影响的Meta分析
Meta-analysis of the effects of blood glucose level on prognosis of patients with acute cerebral infarction complicated by diabetes mellitus
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摘要: 目的: 进一步认识血糖水平对糖尿病合并急性脑梗死(ACI)患者预后的影响。方法: 应用Meta分析方法对15项研究糖尿病血糖水平对糖尿病合并ACI患者预后影响的对照研究进行同质性检验和合并效应量的检验。患者按入院时的空腹血糖水平,分为A、B、C三组。A组:血糖<11.1mmol/L;B组:血糖≥11.1~<16.7mmol/L;C组:血糖≥16.7mmol/L。结果: ①同质性检验:P均>0.05,表明15项研究糖尿病/血糖水平对ACI患者预后影响的对照研究具有同质性,可以合并结果。②合并效应量的检验:ACI正常血糖组的预后显著优于糖尿病组(OR=4.05,95% CI=4.60~5.19),而糖尿病组死亡的危险性则显著高于正常血糖组(OR=3.60,95% CI=2.36~5.49)(P均<0.001)。A组与B组的预后比较差异无显著性(P>0.05),但A组与C组以及B组与C组间的预后比较差异有显著性(P均<0.001)。A、B、C三组的死亡率分别为0、6.16%和40.17%,三组间比较均有显著性差异(P均<0.005)。结论: 糖尿病合并ACI患者预后不良,且血糖愈高,预后愈差。Abstract: Objective: To recognize further the effects of blood glucose level(BGL) on prognosis of patients with acute cerebral infarction(ACI) complicated by diabetes mellitus(DM). Methods: The effects of DM and its BGL on prognosis of patients with ACI complicated by DM were analyzed by meta-analysis in homogeneity test and combined test in 15 studies. All patients were divided into A B C three groups according to theirs fasting BGL, they are blood glucose<11.1mmol/L,≥11.1-< 16.7mmol/L and≥16.7mmol/L respectively. Results: (1)Homogeneity test shows that the cited studies are homogeneous with P>0.05;and (2)combined test shows that the prognosis in normal blood glucose group was significantly better than that in DM group (OR=4.05,95%CI=4.60-5.19), while risk of death in DM group was significantly higher than that in normal blood glucose group (OR=3.60,95% CI=2.36-5.49)(P<0.001).There was not significant difference in prognosis between A group and B group(P>0.05), but there was significant difference in prognosis between A group and C group or between B group and C group(P<0.001). The mortalities of A B C three groups was 0, 6.16% and 40.17% respectively. There were significant differences in mortalities between three groups(P<0.005).Conclusion: The patients with ACI complicated by DM has poor prognosis, and the higher the BGL, the worse the prognosis.
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