目的：研究糖化血红蛋白（HbA1c）在急性缺血性脑卒中（AIS）患者神经功能评定中的价值与临床意 义。方法：AIS患者120例纳入研究，根据入院时空腹血清HbA1c水平分为对照组（HbA1c＜6.5%）和升高组 （HbA1c≥6.5%），各60例。比较2组一般资料；治疗2周后采用MoCA量表对2组进行认知功能评估；入院 后第3天复查头颅CT测定梗死体积和梗死位置；治疗5周时，采用美国国立卫生院卒中量表（NIHSS）评价 神经功能缺损程度；治疗5周后，依据脑卒中患者临床神经功能缺损评分标准进行预后分级。结果：升高组 合并糖尿病患者比例显著高于对照组（P＜0.01）；升高组的MoCA量表总分和各分项得分均明显低于对照 组（P＜0.05）；脑梗死面积较大组患者的HbA1c水平高于梗死面积较小组（P＜0.05）；升高组NIHSS评分明 显高于对照组，且其神经功能缺损重于对照组（均P＜0.05）；升高组预后评价显著差于对照组（P＜0.05）。结 论：HbA1c与AIS患者神经功能受损程度及预后有一定的联系。

To explore the value and clinical significance of glycosylated hemoglobin (HbA1c) in the assessment of neurological function in acute ischemic stroke patients. Methods: A total of 120 patients with acute ischemic stroke were recruited to the study and randomly divided according to serum HbA1c level at admission into the control group (HbA1c<6.5%) and elevated group (HbA1c≥6.5%) with 60 patients per group. General information was compared between the two groups. After 2 weeks of treatment, cognitive function in the two groups was measured using the Montreal Cognitive Assessment (MoCA). Head CT scan was performed on day 3 of admission to assess cerebral infarction volume and location. The degree of neurological dysfunction was assessed by the National Institutes of Health Stroke Scale (NIHSS) at week 5 of treatment. Prognosis was graded using the scale for clinical neurological deficit of stroke patients after 5 weeks of treatment. Results: The proportion of patients with diabetes in the elevated group was significantly higher than that in the control group (P<0.01). The total MoCA score and all subscores of the elevated group were significantly lower than those of the control group (P<0.05). Patients with larger cerebral infarction volumes showed higher levels of HbA1c than those with smaller cerebral infarction volumes (P<0.05). The NIHSS score in the elevated group was significantly higher than that in the control group, and the neurological deficit was also more severe than that in the control group (both P<0.05). The prognosis of the elevated group was significantly worse than that of the control group (P<0.05). Conclusion: Glycated hemoglobin is closely related to the severity of neurological impairment and to prognosis in AIS patients.