Clinical study on relationship between early blood glucose change and prognosis of severe brain injury

WANG Haitao; WANG Jinbo

doi:10.13919/j.issn.2095-6274.2016.05.005

Abstract：Objective To explore the effect of blood glucose fluctuation on the prognosis of patients with severe brain injury. Methods 32 cases of patients with severe brain injury whose glasgow coma scale score≤8 points were selected. According to follow-up, 32 patients were divided into survival group and death group. Random blood glucose was examined at admission and blood samples were collected in the morning to detect the blood routine, liver and kidney function, levels of blood glucose and serum electrolytes on the first, second, third and fifth day after admission. Arterial blood gas analysis was also tested more than twice a day.Results (1) In term of levels of glutamic pyruvic transaminase, glutamic oxalacetic transaminase, urea, serum creatinine, pH and arterial blood CO2 partial pressure, there were no statistically significant differences between two groups; The age at admission showed statistically significant differences between two groups (t=-2.634,P=0.013). (2) Levels of random blood glucose and blood glucose at the first day after admission showed statistically significant differences between two groups (t=-2.716,P=0.011). (3) The level of blood glucose in survival group remained relatively stable at the fifth day and no statistically significant difference was detected within the survival group. In contrast, the level of blood glucose at admission was higher in death group, and decreased after treatment but increased on subsequent days,the levels of blood glucose on the second and third day (P=0.029,P=0.016) statistically significant differences detected within the death group.Conclusions (1) The blood glucose fluctuation of patients with severe brain injury can be used as a marker of disease prognosis to guide treatment adjustment, and be better for disease outcome. (2) It is important to stabilize blood glucose for better prognosis of patients with severe brain injury.