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Akut Stroku Takiben Stres Hormon ve Kan Glikoz Cevabının Mortalite ve Morbidite Üzerine Etkileri

Effects of stress hormone and blood glucose response following acute stroke on mortality and morbidity

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 1997

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
We studied the relation between reactive hyperglycemia, stress hormone response, and prognosis in 40 patients following an acute stroke. The median age of the patients was 60 (range: 20-80) years. Twenty two patients were men. All patients were seen in the first 24 hour after the onset of symptoms. No subject was known to be diabetic and no one had a glycosylated hemoglobin content above the upper limit of normal. Patients were followed up until death or 21 days following their stroke. They were assessed clinically at days 0, 1, 7, 14, and 21. The outcome for each patient was assigned as good (n=19) or poor (n=21). The subjects were also classified as alive (n=29) or dead (n=11) at the 21st day. Blood samples were taken after fasting, for the determination of serum glucose, insülin, glucagon, and cortisol concentrations on days 0, 1, 2, 3, 7, 14, and 21. For all 40 patients, a significant relation was found between the serum glucose concentration and prognosis (p<0.001) and the serum glucose concentration decreased in time (p<0.001). There was also a significant relation between serum glucose concentration and survival (p<0.001). High glucagon (p<0.001) and cortisol (p<0.001) concentrations were related to poor prognosis. Additionally, high glucagon (p<0.01) and cortisol (p<0.001) concentrations were detected in the patients who died. Hyperglycemia following a stroke probably reflects the intensity of the stress hormone response. We suggested that hyperglycemia is a predictor of poor prognosis in patients with stroke. [Journal of Turgut Özal Medical Center 1997;4(1):40-46]
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Abstract (Original Language): 
Akut strok'u takip eden reaktif hiperglisemi, stres hormon cevabı ve prognoz arasındaki ilişki 40 hastada çalışıldı. Hastaların ortalama yaşı 60 'dı (20-80 yaşlar arası); 22 hasta erkekti. Tüm hastalar semptomların başlangıcından itibaren 24 saat geçmemek şartıyla görüldü. Hiç bir hasta diyabetik olarak bilinmiyordu ve normal seviyelerin üstünde glikozile hemoglobin değerine sahip değildi. Hastalar strok'u izleyen 21 günlük süre ya da ölümlerine kadar izlendi. Klinik olarak 0., 1., 7., 14. ve 21. günlerde değerlendirildiler. Prognoz her hasta için iyi (n=19) veya kötü (n=21) olarak belirlendi. Vakalar, bu süre zarfında ölenler (n=ll) ve yaşayanlar (n=29) olarak da sınıflandırıldı. Kan örnekleri hasta aç iken kan glikoz, insülin, glukagon ve kortizol konsantrasyonlarını tayin için 0., 1., 2., 3., 7., 14. ve 21. günlerde alındı. 40 hastanın tamamında kan glikoz konsantrasyonu ile prognoz arasında anlamlı bir ilişki bulundu(p<0.001) ve kan glikoz konsantrasyonunun zamanla azaldığı gözlendi (p<0.001). Aynı zamanda kan glikoz konsantrasyonu ve hayatta kalma arasında da anlamlı bir ilişki vardı (p<0.001). Yüksek glukogan (p<0.001) ve kortizol (p<0.001) konsantrasyonları kötü prognozla ilişkiliydi. Ölen hastalarda da yüksek glukagon (p<0.01) ve kortizol (p<0.001) konsantrasyonları vardı. Strok'u izleyen hiperglisemi muhtemelen stres hormon cevabının şiddetini yansıtmaktadır. Biz hipergliseminin strok'lu hastalarda kötü prognozun öncü bir işaretçisi olduğunu düşünüyoruz. [Turgut Özal Tıp Merkezi Dergisi 1997;4(1):40-46]
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  • Turkish

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