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Стрессовая гипергликемия и течение инсульта
Стрессовая гипергликемия и течение инсульта
Максимова М.Ю., Степанченко О.А. Стрессовая гипергликемия и течение инсульта. Consilium Medicum. 2020 (22); 2: 19–23. DOI: 10.26442/20751753.2020.2.200032
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Аннотация
Аннотация
Введение. Около 1/3 случаев гипергликемии в остром периоде инсульта являются проявлением глобальной стрессовой реакции в виде активации гипоталамо-гипофизарно-надпочечниковой системы с высвобождением кортизола и катехоламинов. Выраженность нейрогормональных и метаболических перестроек отражает тяжесть течения острого периода инсульта и имеет прогностическое значение.
Цель. Оценить связь уровней глюкозы, кортизола и инсулина с тяжестью течения инсульта у больных без сахарного диабета (СД).
Материалы и методы. Проведено обследование 73 больных с инсультом без СД и метаболического синдрома. Средний возраст больных составил 67±9 лет. Гормональное исследование, включающее определение уровня кортизола и инсулина в крови, проводилось у 23 больных с гипергликемией, выявленной в первые 48 ч с момента инсульта.
Результаты. Установлена высокая частота случаев гипергликемии (75,3%) в первые 48 ч с момента инсульта у больных без СД. В группе больных с летальным исходом определялись гиперинсулинемия (49,8±7,2 мкЕд/мл) в сочетании с нормальным уровнем кортизола в крови. В группе с благоприятным течением инсульта выявлены гиперкортизолемия (1015,4±78,1 ммоль/л) и нормальный уровень инсулина в крови.
Заключение. Высокий уровень глюкозы и инсулина в сочетании с нормальным уровнем кортизола связаны с тяжелым течением инсульта и летальным исходом. Реактивное увеличение уровня кортизола и глюкозы в сочетании с нормальным уровнем инсулина характерны для благоприятного течения инсульта с регрессом неврологических нарушений. Стойкая гипергликемия в остром периоде инсульта является фактором риска развития летального исхода.
Ключевые слова: инсульт, стрессиндуцированная гипергликемия, кортизол, инсулин.
Introduction. Approximately 1/3 of all reactive hyperglycemia cases in acute stroke are an indicator of the hypothalamic-pituitary-adrenal system hyperactivation with the release of cortisol and catecholamines. The expression of neurohormonal and metabolic changes is associated with the severity of acute stroke and prognosis.
Aim. To evaluate the association of parameters of cortisol, insulin and glucose levels with clinical severity in patients with stroke.
Materials and methods. Examination of 73 patients (mean age 67±9 years) with acute stroke was сarried out. Patients with diabetes mellitus and metabolic syndrome were excluded from the cohort. Serum cortisol and insulin were evaluated in 23 patients with stress-hyperglycemia within the first 48 h of acute non-diabetic stroke.
Results. A high incidence of hyperglycemia (75.3%) within the first 48 h was found in patients with acute non-diabetic stroke. Hyperinsulinemia (49.8±7.2 μU/ml) and normal serum cortisol levels were determined in patients with a fatal stroke outcome. In patients with a favorable stroke outcome were determined hypercortisolemia (1015.4±78.1 mmol/l) and normal serum insulin levels.
Conclusions. High glucose and insulin levels combined with normal serum cortisol levels are associated with a severe stroke and fatal outcome. Reactive increase of serum cortisol and glucose levels in combination with normal insulin levels is associated with a favorable stroke outcome and regression of neurological deficit (symptoms). Persistent hyperglycemia in acute stroke is a risk factor for fatal outcome (is a fatal outcome risk factor).
Key words: stroke, stress-induced hyperglycemia, cortisol, insulin.
Введение. Около 1/3 случаев гипергликемии в остром периоде инсульта являются проявлением глобальной стрессовой реакции в виде активации гипоталамо-гипофизарно-надпочечниковой системы с высвобождением кортизола и катехоламинов. Выраженность нейрогормональных и метаболических перестроек отражает тяжесть течения острого периода инсульта и имеет прогностическое значение.
Цель. Оценить связь уровней глюкозы, кортизола и инсулина с тяжестью течения инсульта у больных без сахарного диабета (СД).
Материалы и методы. Проведено обследование 73 больных с инсультом без СД и метаболического синдрома. Средний возраст больных составил 67±9 лет. Гормональное исследование, включающее определение уровня кортизола и инсулина в крови, проводилось у 23 больных с гипергликемией, выявленной в первые 48 ч с момента инсульта.
Результаты. Установлена высокая частота случаев гипергликемии (75,3%) в первые 48 ч с момента инсульта у больных без СД. В группе больных с летальным исходом определялись гиперинсулинемия (49,8±7,2 мкЕд/мл) в сочетании с нормальным уровнем кортизола в крови. В группе с благоприятным течением инсульта выявлены гиперкортизолемия (1015,4±78,1 ммоль/л) и нормальный уровень инсулина в крови.
Заключение. Высокий уровень глюкозы и инсулина в сочетании с нормальным уровнем кортизола связаны с тяжелым течением инсульта и летальным исходом. Реактивное увеличение уровня кортизола и глюкозы в сочетании с нормальным уровнем инсулина характерны для благоприятного течения инсульта с регрессом неврологических нарушений. Стойкая гипергликемия в остром периоде инсульта является фактором риска развития летального исхода.
Ключевые слова: инсульт, стрессиндуцированная гипергликемия, кортизол, инсулин.
________________________________________________
Introduction. Approximately 1/3 of all reactive hyperglycemia cases in acute stroke are an indicator of the hypothalamic-pituitary-adrenal system hyperactivation with the release of cortisol and catecholamines. The expression of neurohormonal and metabolic changes is associated with the severity of acute stroke and prognosis.
Aim. To evaluate the association of parameters of cortisol, insulin and glucose levels with clinical severity in patients with stroke.
Materials and methods. Examination of 73 patients (mean age 67±9 years) with acute stroke was сarried out. Patients with diabetes mellitus and metabolic syndrome were excluded from the cohort. Serum cortisol and insulin were evaluated in 23 patients with stress-hyperglycemia within the first 48 h of acute non-diabetic stroke.
Results. A high incidence of hyperglycemia (75.3%) within the first 48 h was found in patients with acute non-diabetic stroke. Hyperinsulinemia (49.8±7.2 μU/ml) and normal serum cortisol levels were determined in patients with a fatal stroke outcome. In patients with a favorable stroke outcome were determined hypercortisolemia (1015.4±78.1 mmol/l) and normal serum insulin levels.
Conclusions. High glucose and insulin levels combined with normal serum cortisol levels are associated with a severe stroke and fatal outcome. Reactive increase of serum cortisol and glucose levels in combination with normal insulin levels is associated with a favorable stroke outcome and regression of neurological deficit (symptoms). Persistent hyperglycemia in acute stroke is a risk factor for fatal outcome (is a fatal outcome risk factor).
Key words: stroke, stress-induced hyperglycemia, cortisol, insulin.
Полный текст
Список литературы
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[Piradov M.A., Tanashyan M.M., Maksimova M.Yu. Stroke: modern technologies for diagnosis and treatment. Ed. M.A.Piradov, M.M.Tanashyan, M.Yu.Maksimov. 3rd ed. Moscow: MEDpress-inform, 2018. DOI: 10.24421/MP.2018.18.15909 (in Russian).]
2. Скворцова В.И., Шетова И.М., Какорина Е.П. и др. Организация помощи пациентам с инсультом в России. Итоги 10 лет реализации Комплекса мероприятий по совершенствованию медицинской помощи пациентам с острыми нарушениями мозгового кровообращения.
Анналы клинической и экспериментальной неврологии. 2018; 12 (3): 5–12. DOI: 10.25692/ACEN.2018.3.7
[Skvortsova V.I., Shetova I.M., Kakorina E.P. et al. Organizatsiia pomoshchi patsientam s insul'tom v Rossii. Itogi 10 let realizatsii Kompleksa meropriiatii po sovershenstvovaniiu meditsinskoi pomoshchi patsientam s ostrymi narusheniiami mozgovogo krovoobrashcheniia. Annaly klinicheskoi i eksperimental'noi nevrologii. 2018; 12 (3): 5–12. DOI: 10.25692/ACEN.2018.3.7 (in Russian).]
3. Пирадов М.А., Максимова М.Ю., Танашян М.М. Инсульт: пошаговая инструкция. Руководство для врачей. M.: ГЭОТАР-Медиа, 2019. DOI: 10.33029/9704-4910-3-ins-2019-1-272
[Piradov M.A., Maksimova M.Yu., Tanashyan M.M. Stroke: step by step instructions. A guide for doctors. Moscow: GEOTAR-Media, 2019. DOI: 10.33029/9704-4910-3-ins-2019-1-272 (in Russian).]
4. Van Kooten F, Hoogerbrugge N, Naarding P, Koudstaal PJ. Hyperglycemia in the acute phase of stroke is not caused by stress. Stroke 1993; 24 (8): 1129–32. DOI: 10.1161/01.str.24.8.1129
5. Capes SE, Hunt D, Malmberg K et al. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke 2001; 32 (10): 2426–32. DOI: 10.1161/hs1001.096194
6. Kes VB, Solter VV, Supanc V, Demarin V. Impact of hyperglycemia on ischemic stroke mortality in diabetic and non-diabetic patients. Ann Saudi Med 2007; 27 (5): 352–5. DOI: 10.5144/0256-4947.2007.352
7. Tziomalos K, Dimitriou P, Bouziana SD et al. Stress hyperglycemia and acute ischemic stroke in-hospital outcome. Metabolism 2017; 67: 99–105. DOI: 10.1016/j.metabol.2016.11.011
8. Vanacker P, Heldner MR, Seiffge D et al. ASTRAL-R score predicts non-recanalisation after intravenous thrombolysis in acute ischaemic stroke. Thrombosis Haemostasis 2015; 113 (5): 911–7. PMID: 25854290. DOI: http://dx.doi.org/10.1160/TH14-06-0482
9. Barth E, Albuszies G, Baumgart K et al. Glucose metabolism and catecholamines. Crit Care Med 2007; 35 (Suppl. 9): S508–18. DOI: 10.1097/01.CCM.0000278047.06965.20
10. Zhu B, Pan Y, Jing J et al. Stress Hyperglycemia and Outcome of Non-diabetic Patients After Acute Ischemic Stroke. Front Neurol 2019; 10: 1003. DOI: 10.3389/fneur.2019.01003
11. Kamada H, Yu F, Nito C, Chan PH. Influence of hyperglycemia on oxidative stress and matrix metalloproteinase-9 activation after focal cerebral ischemia/reperfusion in rats: relation to blood-brain barrier dysfunction. Stroke 2007; 38 (3): 1044–9. DOI: 10.1161/01.STR.0000258041.75739.cb
12. Tsuruta R, Fujita M, Ono T et al. Hyperglycemia enhances excessive superoxide anion radical generation, oxidative stress, early inflammation, and endothelial injury in forebrain ischemia/reperfusion rats. Brain Res 2010; 1309: 155–63. DOI: 10.1016/j.brainres.2009.10.065
13. Li WA, Moore-Langston S, Chakraborty T et al. Hyperglycemia in stroke and possible treatments. Neurol Res 2013; 35 (5): 479–91. DOI: 10.1179/1743132813Y.0000000209
14. Heiss WD, Kessler J, Karbe H et al. Cerebral glucose metabolism as a predictor of recovery from aphasia in ischemic stroke. Arch Neurol 1993; 50 (9): 958–64. DOI: 10.1001/archneur. 1993.00540090059011
15. Douketis J. Review: stress hyperglycemia after ischemic stroke indicates a greater risk for death in patients without diabetes. ACP J Club 2002; 136 (3): 114. DOI: 10.7326/acpjc-2002-136-3-114
16. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet 2009; 373: 1798–807. DOI:10.1016/S0140-6736(09)60553-5
17. Ernaga Lorea A, Hernández Morhain MC, Ollero García-Agulló MD et al. Prognostic value of blood glucose in emergency room and glycosylated hemoglobin in patients who have suffered an acute cerebrovascular event. Med Clin (Barc) 2017; 149 (1): 17–23. DOI: 10.1016/j.medcli.2016.12.029
18. Talukder RK, Uddin MJ, Battacharjee M et al. Stress Hyperglycemia and Stroke Outcome in Patients with Acute Stroke. Mymensingh Med J 2018; 27 (4): 685–92. PMID: 30487481
19. Schurr A. Bench-to-bedside review: a possible resolution of the glucose paradox of cerebral ischemia. Crit Care 2002; 6 (4): 330–4. DOI: 10.1186/cc1520
20. Parsons MW, Barber PA, Desmond PM et al. Acute hyperglycemia adversely affects stroke outcome: a magnetic resonance imaging and spectroscopy study. Ann Neurol 2002; 52: 20–8. DOI:10.1002/ana.10241
21. Baird TA, Parsons MW, Phanh T et al. Persistent poststroke hyperglycemia is independently associated with infarct volume expansion and worse clinical outcome. Stroke 2003; 34: 2208–14. DOI: 10.1161/01.STR.0000085087.41330.FF
22. Allport LE, Butcher KS, Baird TA et al. Insular cortical ischemia is independently associated with acute stress hyperglycemia. Stroke 2004; 35 (8): 1886–91. DOI: 10.1161/01.STR.0000133687.33868.71
23. Su YW, Hsu CY, Guo YW, Chen HS. Usefulness of the plasma glucose concentration-to-HbA1c ratio in predicting clinical outcomes during acute illness with extreme hyperglycaemia. Diabetes Metab 2017; 43: 40–7. DOI: 10.1016/j.diabet.2016.07.036
24. Garg R, Chaudhuri A, Munschauer F, Dandona P. Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke 2006; 37 (1): 267–73. DOI:10.1161/01.STR.0000195175.29487.30
25. Roh E, Song DK, Kim MS. Emerging role of the brain in the homeostatic regulation of energy and glucose metabolism. Exp Mol Med 2016; 48: e216. DOI: 10.1038/emm.2016.4
26. Wang YY, Lin SY, Chuang YH et al. Activation of hepatic inflammatory pathways by catecholamines is associated with hepatic insulin resistance in male ischemic stroke rats. Endocrinology 2014; 155 (4): 1235–46. DOI: 10.1210/en.2013-1593
27. Seo SY, Kim EY, Kim H, Gwag BJ. Neuroprotective effect of high glucose against NMDA, free radical, and oxygen-glucose deprivation through enhanced mitochondrial potentials. J Neurosci 1999; 19 (20): 8849–55. PMID: 10516304
28. Chen X, Liu Z, Miao J et al. High stress hyperglycemia ratio predicts poor outcome after mechanical thrombectomy for ischemic stroke. J Stroke Cerebrovasc Dis 2019; 28: 1668–73. DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.022
2. Skvortsova V.I., Shetova I.M., Kakorina E.P. et al. Organizatsiia pomoshchi patsientam s insul'tom v Rossii. Itogi 10 let realizatsii Kompleksa meropriiatii po sovershenstvovaniiu meditsinskoi pomoshchi patsientam s ostrymi narusheniiami mozgovogo krovoobrashcheniia. Annaly klinicheskoi i eksperimental'noi nevrologii. 2018; 12 (3): 5–12. DOI: 10.25692/ACEN.2018.3.7 (in Russian).
3. Piradov M.A., Maksimova M.Yu., Tanashyan M.M. Stroke: step by step instructions. A guide for doctors. Moscow: GEOTAR-Media, 2019. DOI: 10.33029/9704-4910-3-ins-2019-1-272 (in Russian).
4. Van Kooten F, Hoogerbrugge N, Naarding P, Koudstaal PJ. Hyperglycemia in the acute phase of stroke is not caused by stress. Stroke 1993; 24 (8): 1129–32. DOI: 10.1161/01.str.24.8.1129
5. Capes SE, Hunt D, Malmberg K et al. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke 2001; 32 (10): 2426–32. DOI: 10.1161/hs1001.096194
6. Kes VB, Solter VV, Supanc V, Demarin V. Impact of hyperglycemia on ischemic stroke mortality in diabetic and non-diabetic patients. Ann Saudi Med 2007; 27 (5): 352–5. DOI: 10.5144/0256-4947.2007.352
7. Tziomalos K, Dimitriou P, Bouziana SD et al. Stress hyperglycemia and acute ischemic stroke in-hospital outcome. Metabolism 2017; 67: 99–105. DOI: 10.1016/j.metabol.2016.11.011
8. Vanacker P, Heldner MR, Seiffge D et al. ASTRAL-R score predicts non-recanalisation after intravenous thrombolysis in acute ischaemic stroke. Thrombosis Haemostasis 2015; 113 (5): 911–7. PMID: 25854290. DOI: http://dx.doi.org/10.1160/TH14-06-0482
9. Barth E, Albuszies G, Baumgart K et al. Glucose metabolism and catecholamines. Crit Care Med 2007; 35 (Suppl. 9): S508–18. DOI: 10.1097/01.CCM.0000278047.06965.20
10. Zhu B, Pan Y, Jing J et al. Stress Hyperglycemia and Outcome of Non-diabetic Patients After Acute Ischemic Stroke. Front Neurol 2019; 10: 1003. DOI: 10.3389/fneur.2019.01003
11. Kamada H, Yu F, Nito C, Chan PH. Influence of hyperglycemia on oxidative stress and matrix metalloproteinase-9 activation after focal cerebral ischemia/reperfusion in rats: relation to blood-brain barrier dysfunction. Stroke 2007; 38 (3): 1044–9. DOI: 10.1161/01.STR.0000258041.75739.cb
12. Tsuruta R, Fujita M, Ono T et al. Hyperglycemia enhances excessive superoxide anion radical generation, oxidative stress, early inflammation, and endothelial injury in forebrain ischemia/reperfusion rats. Brain Res 2010; 1309: 155–63. DOI: 10.1016/j.brainres.2009.10.065
13. Li WA, Moore-Langston S, Chakraborty T et al. Hyperglycemia in stroke and possible treatments. Neurol Res 2013; 35 (5): 479–91. DOI: 10.1179/1743132813Y.0000000209
14. Heiss WD, Kessler J, Karbe H et al. Cerebral glucose metabolism as a predictor of recovery from aphasia in ischemic stroke. Arch Neurol 1993; 50 (9): 958–64. DOI: 10.1001/archneur. 1993.00540090059011
15. Douketis J. Review: stress hyperglycemia after ischemic stroke indicates a greater risk for death in patients without diabetes. ACP J Club 2002; 136 (3): 114. DOI: 10.7326/acpjc-2002-136-3-114
16. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet 2009; 373: 1798–807. DOI:10.1016/S0140-6736(09)60553-5
17. Ernaga Lorea A, Hernández Morhain MC, Ollero García-Agulló MD et al. Prognostic value of blood glucose in emergency room and glycosylated hemoglobin in patients who have suffered an acute cerebrovascular event. Med Clin (Barc) 2017; 149 (1): 17–23. DOI: 10.1016/j.medcli.2016.12.029
18. Talukder RK, Uddin MJ, Battacharjee M et al. Stress Hyperglycemia and Stroke Outcome in Patients with Acute Stroke. Mymensingh Med J 2018; 27 (4): 685–92. PMID: 30487481
19. Schurr A. Bench-to-bedside review: a possible resolution of the glucose paradox of cerebral ischemia. Crit Care 2002; 6 (4): 330–4. DOI: 10.1186/cc1520
20. Parsons MW, Barber PA, Desmond PM et al. Acute hyperglycemia adversely affects stroke outcome: a magnetic resonance imaging and spectroscopy study. Ann Neurol 2002; 52: 20–8. DOI:10.1002/ana.10241
21. Baird TA, Parsons MW, Phanh T et al. Persistent poststroke hyperglycemia is independently associated with infarct volume expansion and worse clinical outcome. Stroke 2003; 34: 2208–14. DOI: 10.1161/01.STR.0000085087.41330.FF
22. Allport LE, Butcher KS, Baird TA et al. Insular cortical ischemia is independently associated with acute stress hyperglycemia. Stroke 2004; 35 (8): 1886–91. DOI: 10.1161/01.STR.0000133687.33868.71
23. Su YW, Hsu CY, Guo YW, Chen HS. Usefulness of the plasma glucose concentration-to-HbA1c ratio in predicting clinical outcomes during acute illness with extreme hyperglycaemia. Diabetes Metab 2017; 43: 40–7. DOI: 10.1016/j.diabet.2016.07.036
24. Garg R, Chaudhuri A, Munschauer F, Dandona P. Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke 2006; 37 (1): 267–73. DOI:10.1161/01.STR.0000195175.29487.30
25. Roh E, Song DK, Kim MS. Emerging role of the brain in the homeostatic regulation of energy and glucose metabolism. Exp Mol Med 2016; 48: e216. DOI: 10.1038/emm.2016.4
26. Wang YY, Lin SY, Chuang YH et al. Activation of hepatic inflammatory pathways by catecholamines is associated with hepatic insulin resistance in male ischemic stroke rats. Endocrinology 2014; 155 (4): 1235–46. DOI: 10.1210/en.2013-1593
27. Seo SY, Kim EY, Kim H, Gwag BJ. Neuroprotective effect of high glucose against NMDA, free radical, and oxygen-glucose deprivation through enhanced mitochondrial potentials. J Neurosci 1999; 19 (20): 8849–55. PMID: 10516304
28. Chen X, Liu Z, Miao J et al. High stress hyperglycemia ratio predicts poor outcome after mechanical thrombectomy for ischemic stroke. J Stroke Cerebrovasc Dis 2019; 28: 1668–73. DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.022
[Piradov M.A., Tanashyan M.M., Maksimova M.Yu. Stroke: modern technologies for diagnosis and treatment. Ed. M.A.Piradov, M.M.Tanashyan, M.Yu.Maksimov. 3rd ed. Moscow: MEDpress-inform, 2018. DOI: 10.24421/MP.2018.18.15909 (in Russian).]
2. Скворцова В.И., Шетова И.М., Какорина Е.П. и др. Организация помощи пациентам с инсультом в России. Итоги 10 лет реализации Комплекса мероприятий по совершенствованию медицинской помощи пациентам с острыми нарушениями мозгового кровообращения.
Анналы клинической и экспериментальной неврологии. 2018; 12 (3): 5–12. DOI: 10.25692/ACEN.2018.3.7
[Skvortsova V.I., Shetova I.M., Kakorina E.P. et al. Organizatsiia pomoshchi patsientam s insul'tom v Rossii. Itogi 10 let realizatsii Kompleksa meropriiatii po sovershenstvovaniiu meditsinskoi pomoshchi patsientam s ostrymi narusheniiami mozgovogo krovoobrashcheniia. Annaly klinicheskoi i eksperimental'noi nevrologii. 2018; 12 (3): 5–12. DOI: 10.25692/ACEN.2018.3.7 (in Russian).]
3. Пирадов М.А., Максимова М.Ю., Танашян М.М. Инсульт: пошаговая инструкция. Руководство для врачей. M.: ГЭОТАР-Медиа, 2019. DOI: 10.33029/9704-4910-3-ins-2019-1-272
[Piradov M.A., Maksimova M.Yu., Tanashyan M.M. Stroke: step by step instructions. A guide for doctors. Moscow: GEOTAR-Media, 2019. DOI: 10.33029/9704-4910-3-ins-2019-1-272 (in Russian).]
4. Van Kooten F, Hoogerbrugge N, Naarding P, Koudstaal PJ. Hyperglycemia in the acute phase of stroke is not caused by stress. Stroke 1993; 24 (8): 1129–32. DOI: 10.1161/01.str.24.8.1129
5. Capes SE, Hunt D, Malmberg K et al. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke 2001; 32 (10): 2426–32. DOI: 10.1161/hs1001.096194
6. Kes VB, Solter VV, Supanc V, Demarin V. Impact of hyperglycemia on ischemic stroke mortality in diabetic and non-diabetic patients. Ann Saudi Med 2007; 27 (5): 352–5. DOI: 10.5144/0256-4947.2007.352
7. Tziomalos K, Dimitriou P, Bouziana SD et al. Stress hyperglycemia and acute ischemic stroke in-hospital outcome. Metabolism 2017; 67: 99–105. DOI: 10.1016/j.metabol.2016.11.011
8. Vanacker P, Heldner MR, Seiffge D et al. ASTRAL-R score predicts non-recanalisation after intravenous thrombolysis in acute ischaemic stroke. Thrombosis Haemostasis 2015; 113 (5): 911–7. PMID: 25854290. DOI: http://dx.doi.org/10.1160/TH14-06-0482
9. Barth E, Albuszies G, Baumgart K et al. Glucose metabolism and catecholamines. Crit Care Med 2007; 35 (Suppl. 9): S508–18. DOI: 10.1097/01.CCM.0000278047.06965.20
10. Zhu B, Pan Y, Jing J et al. Stress Hyperglycemia and Outcome of Non-diabetic Patients After Acute Ischemic Stroke. Front Neurol 2019; 10: 1003. DOI: 10.3389/fneur.2019.01003
11. Kamada H, Yu F, Nito C, Chan PH. Influence of hyperglycemia on oxidative stress and matrix metalloproteinase-9 activation after focal cerebral ischemia/reperfusion in rats: relation to blood-brain barrier dysfunction. Stroke 2007; 38 (3): 1044–9. DOI: 10.1161/01.STR.0000258041.75739.cb
12. Tsuruta R, Fujita M, Ono T et al. Hyperglycemia enhances excessive superoxide anion radical generation, oxidative stress, early inflammation, and endothelial injury in forebrain ischemia/reperfusion rats. Brain Res 2010; 1309: 155–63. DOI: 10.1016/j.brainres.2009.10.065
13. Li WA, Moore-Langston S, Chakraborty T et al. Hyperglycemia in stroke and possible treatments. Neurol Res 2013; 35 (5): 479–91. DOI: 10.1179/1743132813Y.0000000209
14. Heiss WD, Kessler J, Karbe H et al. Cerebral glucose metabolism as a predictor of recovery from aphasia in ischemic stroke. Arch Neurol 1993; 50 (9): 958–64. DOI: 10.1001/archneur. 1993.00540090059011
15. Douketis J. Review: stress hyperglycemia after ischemic stroke indicates a greater risk for death in patients without diabetes. ACP J Club 2002; 136 (3): 114. DOI: 10.7326/acpjc-2002-136-3-114
16. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet 2009; 373: 1798–807. DOI:10.1016/S0140-6736(09)60553-5
17. Ernaga Lorea A, Hernández Morhain MC, Ollero García-Agulló MD et al. Prognostic value of blood glucose in emergency room and glycosylated hemoglobin in patients who have suffered an acute cerebrovascular event. Med Clin (Barc) 2017; 149 (1): 17–23. DOI: 10.1016/j.medcli.2016.12.029
18. Talukder RK, Uddin MJ, Battacharjee M et al. Stress Hyperglycemia and Stroke Outcome in Patients with Acute Stroke. Mymensingh Med J 2018; 27 (4): 685–92. PMID: 30487481
19. Schurr A. Bench-to-bedside review: a possible resolution of the glucose paradox of cerebral ischemia. Crit Care 2002; 6 (4): 330–4. DOI: 10.1186/cc1520
20. Parsons MW, Barber PA, Desmond PM et al. Acute hyperglycemia adversely affects stroke outcome: a magnetic resonance imaging and spectroscopy study. Ann Neurol 2002; 52: 20–8. DOI:10.1002/ana.10241
21. Baird TA, Parsons MW, Phanh T et al. Persistent poststroke hyperglycemia is independently associated with infarct volume expansion and worse clinical outcome. Stroke 2003; 34: 2208–14. DOI: 10.1161/01.STR.0000085087.41330.FF
22. Allport LE, Butcher KS, Baird TA et al. Insular cortical ischemia is independently associated with acute stress hyperglycemia. Stroke 2004; 35 (8): 1886–91. DOI: 10.1161/01.STR.0000133687.33868.71
23. Su YW, Hsu CY, Guo YW, Chen HS. Usefulness of the plasma glucose concentration-to-HbA1c ratio in predicting clinical outcomes during acute illness with extreme hyperglycaemia. Diabetes Metab 2017; 43: 40–7. DOI: 10.1016/j.diabet.2016.07.036
24. Garg R, Chaudhuri A, Munschauer F, Dandona P. Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke 2006; 37 (1): 267–73. DOI:10.1161/01.STR.0000195175.29487.30
25. Roh E, Song DK, Kim MS. Emerging role of the brain in the homeostatic regulation of energy and glucose metabolism. Exp Mol Med 2016; 48: e216. DOI: 10.1038/emm.2016.4
26. Wang YY, Lin SY, Chuang YH et al. Activation of hepatic inflammatory pathways by catecholamines is associated with hepatic insulin resistance in male ischemic stroke rats. Endocrinology 2014; 155 (4): 1235–46. DOI: 10.1210/en.2013-1593
27. Seo SY, Kim EY, Kim H, Gwag BJ. Neuroprotective effect of high glucose against NMDA, free radical, and oxygen-glucose deprivation through enhanced mitochondrial potentials. J Neurosci 1999; 19 (20): 8849–55. PMID: 10516304
28. Chen X, Liu Z, Miao J et al. High stress hyperglycemia ratio predicts poor outcome after mechanical thrombectomy for ischemic stroke. J Stroke Cerebrovasc Dis 2019; 28: 1668–73. DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.022
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2. Skvortsova V.I., Shetova I.M., Kakorina E.P. et al. Organizatsiia pomoshchi patsientam s insul'tom v Rossii. Itogi 10 let realizatsii Kompleksa meropriiatii po sovershenstvovaniiu meditsinskoi pomoshchi patsientam s ostrymi narusheniiami mozgovogo krovoobrashcheniia. Annaly klinicheskoi i eksperimental'noi nevrologii. 2018; 12 (3): 5–12. DOI: 10.25692/ACEN.2018.3.7 (in Russian).
3. Piradov M.A., Maksimova M.Yu., Tanashyan M.M. Stroke: step by step instructions. A guide for doctors. Moscow: GEOTAR-Media, 2019. DOI: 10.33029/9704-4910-3-ins-2019-1-272 (in Russian).
4. Van Kooten F, Hoogerbrugge N, Naarding P, Koudstaal PJ. Hyperglycemia in the acute phase of stroke is not caused by stress. Stroke 1993; 24 (8): 1129–32. DOI: 10.1161/01.str.24.8.1129
5. Capes SE, Hunt D, Malmberg K et al. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke 2001; 32 (10): 2426–32. DOI: 10.1161/hs1001.096194
6. Kes VB, Solter VV, Supanc V, Demarin V. Impact of hyperglycemia on ischemic stroke mortality in diabetic and non-diabetic patients. Ann Saudi Med 2007; 27 (5): 352–5. DOI: 10.5144/0256-4947.2007.352
7. Tziomalos K, Dimitriou P, Bouziana SD et al. Stress hyperglycemia and acute ischemic stroke in-hospital outcome. Metabolism 2017; 67: 99–105. DOI: 10.1016/j.metabol.2016.11.011
8. Vanacker P, Heldner MR, Seiffge D et al. ASTRAL-R score predicts non-recanalisation after intravenous thrombolysis in acute ischaemic stroke. Thrombosis Haemostasis 2015; 113 (5): 911–7. PMID: 25854290. DOI: http://dx.doi.org/10.1160/TH14-06-0482
9. Barth E, Albuszies G, Baumgart K et al. Glucose metabolism and catecholamines. Crit Care Med 2007; 35 (Suppl. 9): S508–18. DOI: 10.1097/01.CCM.0000278047.06965.20
10. Zhu B, Pan Y, Jing J et al. Stress Hyperglycemia and Outcome of Non-diabetic Patients After Acute Ischemic Stroke. Front Neurol 2019; 10: 1003. DOI: 10.3389/fneur.2019.01003
11. Kamada H, Yu F, Nito C, Chan PH. Influence of hyperglycemia on oxidative stress and matrix metalloproteinase-9 activation after focal cerebral ischemia/reperfusion in rats: relation to blood-brain barrier dysfunction. Stroke 2007; 38 (3): 1044–9. DOI: 10.1161/01.STR.0000258041.75739.cb
12. Tsuruta R, Fujita M, Ono T et al. Hyperglycemia enhances excessive superoxide anion radical generation, oxidative stress, early inflammation, and endothelial injury in forebrain ischemia/reperfusion rats. Brain Res 2010; 1309: 155–63. DOI: 10.1016/j.brainres.2009.10.065
13. Li WA, Moore-Langston S, Chakraborty T et al. Hyperglycemia in stroke and possible treatments. Neurol Res 2013; 35 (5): 479–91. DOI: 10.1179/1743132813Y.0000000209
14. Heiss WD, Kessler J, Karbe H et al. Cerebral glucose metabolism as a predictor of recovery from aphasia in ischemic stroke. Arch Neurol 1993; 50 (9): 958–64. DOI: 10.1001/archneur. 1993.00540090059011
15. Douketis J. Review: stress hyperglycemia after ischemic stroke indicates a greater risk for death in patients without diabetes. ACP J Club 2002; 136 (3): 114. DOI: 10.7326/acpjc-2002-136-3-114
16. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet 2009; 373: 1798–807. DOI:10.1016/S0140-6736(09)60553-5
17. Ernaga Lorea A, Hernández Morhain MC, Ollero García-Agulló MD et al. Prognostic value of blood glucose in emergency room and glycosylated hemoglobin in patients who have suffered an acute cerebrovascular event. Med Clin (Barc) 2017; 149 (1): 17–23. DOI: 10.1016/j.medcli.2016.12.029
18. Talukder RK, Uddin MJ, Battacharjee M et al. Stress Hyperglycemia and Stroke Outcome in Patients with Acute Stroke. Mymensingh Med J 2018; 27 (4): 685–92. PMID: 30487481
19. Schurr A. Bench-to-bedside review: a possible resolution of the glucose paradox of cerebral ischemia. Crit Care 2002; 6 (4): 330–4. DOI: 10.1186/cc1520
20. Parsons MW, Barber PA, Desmond PM et al. Acute hyperglycemia adversely affects stroke outcome: a magnetic resonance imaging and spectroscopy study. Ann Neurol 2002; 52: 20–8. DOI:10.1002/ana.10241
21. Baird TA, Parsons MW, Phanh T et al. Persistent poststroke hyperglycemia is independently associated with infarct volume expansion and worse clinical outcome. Stroke 2003; 34: 2208–14. DOI: 10.1161/01.STR.0000085087.41330.FF
22. Allport LE, Butcher KS, Baird TA et al. Insular cortical ischemia is independently associated with acute stress hyperglycemia. Stroke 2004; 35 (8): 1886–91. DOI: 10.1161/01.STR.0000133687.33868.71
23. Su YW, Hsu CY, Guo YW, Chen HS. Usefulness of the plasma glucose concentration-to-HbA1c ratio in predicting clinical outcomes during acute illness with extreme hyperglycaemia. Diabetes Metab 2017; 43: 40–7. DOI: 10.1016/j.diabet.2016.07.036
24. Garg R, Chaudhuri A, Munschauer F, Dandona P. Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke 2006; 37 (1): 267–73. DOI:10.1161/01.STR.0000195175.29487.30
25. Roh E, Song DK, Kim MS. Emerging role of the brain in the homeostatic regulation of energy and glucose metabolism. Exp Mol Med 2016; 48: e216. DOI: 10.1038/emm.2016.4
26. Wang YY, Lin SY, Chuang YH et al. Activation of hepatic inflammatory pathways by catecholamines is associated with hepatic insulin resistance in male ischemic stroke rats. Endocrinology 2014; 155 (4): 1235–46. DOI: 10.1210/en.2013-1593
27. Seo SY, Kim EY, Kim H, Gwag BJ. Neuroprotective effect of high glucose against NMDA, free radical, and oxygen-glucose deprivation through enhanced mitochondrial potentials. J Neurosci 1999; 19 (20): 8849–55. PMID: 10516304
28. Chen X, Liu Z, Miao J et al. High stress hyperglycemia ratio predicts poor outcome after mechanical thrombectomy for ischemic stroke. J Stroke Cerebrovasc Dis 2019; 28: 1668–73. DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.022
Авторы
М.Ю. Максимова*1,2, О.А. Степанченко2
1 ФГБНУ «Научный центр неврологии», Москва, Россия;
2 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия
*ncnmaximova@mail.ru
1 Research Center of Neurology, Moscow, Russia;
2 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
*ncnmaximova@mail.ru
1 ФГБНУ «Научный центр неврологии», Москва, Россия;
2 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия
*ncnmaximova@mail.ru
________________________________________________
1 Research Center of Neurology, Moscow, Russia;
2 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
*ncnmaximova@mail.ru
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