The role of hyperglycemia in acute stroke.

摘要: Background Ischemic stroke is a leading cause of death and long-term disability, hyperglycemia believed to aggravate cerebral ischemia. Objectives To review animal human studies on the relationship between brain ischemia that elucidate some mechanisms for deleterious effect hyperglycemia. discuss present future clinical recommendations glucose control. Methods Computerized data sources published indexes articles from 1976 through 2000 were searched evaluated association hyperglycemia, focused experimental models hyperglycemic animals with focal global Results Most have shown in acute stroke, admission patients or without diabetes associated worse outcome than This more consistent nonlacunar type stroke. Animal support these findings by showing both postischemic exaggerates following damaging processes: intracellular acidosis, accumulation extracellular glutamate, edema formation, blood-brain barrier disruption, tendency hemorrhagic transformation. Insulin treatment was found beneficial ischemia, which may be mediated glucose-reduction direct neuroprotection. Conclusions show early especially Clinical trials intensive insulin are needed. Meanwhile simple measures avoid excessive recommended.