糖耐量与脑梗死患者颈动脉粥样硬化的关系  

Relationship between glucose tolerance and carotid atherosclerosis in patients with cerebral infarction

作　　者：许寅宏[1] 徐恩[2] 邱少东[1] 

机构地区：[1]广州医学院第二附属医院超声科,广东广州510260 [2]广州医学院第二附属医院神经内科,广东广州510260

出　　处：《中风与神经疾病杂志》2012年第4期325-327,共3页Journal of Apoplexy and Nervous Diseases

基　　金：广州市教育局广州市属高校科技计划项目(08A002);广州市民生科技重大专项(12B282020016)

摘　　要：目的探讨糖耐量异常的脑梗死患者糖耐量的异常变化与颈动脉粥样硬化的关系。方法选择脑梗死患者160例,通过口服葡萄糖耐量试验(OGTT)将患者分为糖耐量正常组(NGT,n=60例),糖耐量异常组(IGT,n=53例),糖尿病组(DM,n=47例),测定各项血液生化指标,采用双功能彩色多普勒超声检测颈动脉内膜中层厚度(IMT)及斑块。结果脑梗死患者IGT组、DM组颈动脉IMT、斑块检出率及不稳定性斑块发生率均高于NGT组(P<0.05)。IGT组与DM组的颈动脉IMT、颈动脉斑块检出率及不稳定性斑块发生率差异无统计学意义(P>0.05)。脑梗死患者IGT组颈动脉IMT与血糖基化血红蛋白(HbA1C)水平呈正相关(r=0.264,P=0.01),与服糖后2h血糖(2h-PG)呈正相关(r=0.262,P=0.001)。结论脑梗死合并糖耐量异常患者存在明显的动脉粥样硬化表现,IGT是促进动脉粥样硬化发生的重要危险因素,具有促斑块不稳定作用,也是脑梗死的危险因素。Objective To investigate the relationship between the change of glucose tolerance and carotid atherosclerosis in cerebral infarction patients with impaired glucose tolerance（IGT）.Methods One hundred and sixty patients who had cerebral infarction received 75g oral glucose tolerance test（OGTT）.According to the results of OGTT,patients were divided into normal glucose tolerance group（NGT,n=60）,IGT group（n=53）and diabetes mellitus group（DM,n=47）.Some plasma biochemical parameters were measured.Intima-medial thickness（IMT）and the plaque of carotid were examined with color Doppler ultrasound.Results The IMT of carotid,and the prevalence of carotid plaque and unstable plaque of the IGT group and DM group were higher than those of the NGT group（P0.05）.There were no difference of IMT,the prevalence of CAS plaque and unstable plaque between DM group and IGT group（P0.05）.IMT of carotid in cerebral infarction patients with IGT was positively correlated with plasma glycosylated hemoglobin（HbA1C）levels（r=0.264,P=0.01）and 2-hour PG（r=0.262,P=0.001）.Conclusion Cerebral infarction patients with IGT have more severe atherosclerotic manifestations compared with those with normal glucose tolerance.IGT can increase instability of the plaque and is the risk factor for atherosclerosis and ischemic stroke.

关 键 词：脑梗死 动脉粥样硬化 糖耐量异常 彩色多普勒血流成像 

分 类 号：R743.1[医药卫生—神经病学与精神病学]