急性缺血性脑卒中患者脑白质病变与HbA1c水平的相关性分析  

The association of cerebral white matter disease with hemoglobin A1c levels in acute ischemic stroke patients

作　　者：周治平[1] 赖玉洁[1] 王年臻 杨国帅[1] 王爱岳[1] 余丹[1] 

机构地区：[1]海口市人民医院神经内科,海南海口570208

出　　处：《中风与神经疾病杂志》2016年第4期346-348,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨初发急性缺血性脑卒中患者脑白质病变(cerebral white matter disease,WMD)的血管危险因素,及其与Hb A1c水平的相关性。方法纳入初发急性缺血性脑卒中患者,收集患者入院当时及入院后第2天的影像学资料和血生化检查资料,根据患者WMD分级标准将患者分为4级。详细记录患者的人口统计学资料,血管危险因素和FLAIR序列显示的WMD影像资料并进行比较和分析。结果共纳入512例首发急性缺血性脑卒中患者,其中男性320(62.5%)例,460(89.8%)例患者存在WMD,其中无WMD患者52例,轻度WMD患者205例,中度WMD患者139例,重度WMD患者116例。单变量分析显示,高龄、高血压、肾小球滤过率降低,Hb A1c水平降低,男性与WMD呈正相关(P<0.05)。进一步的多变量Logistic回归发现,高龄、高血压和Hb A1c增高是WMD的独立危险因素。结论急性缺血性脑卒中患者Hb A1c增高是WMD的独立危险因素之一。Objective This study was conducted to investigate the association of cerebral white matter disease（ WMD） on MRI with vascular risk factors and laboratory findings in consecutive first acute ischemic stroke patients.Methods Acute ischemic stroke patients underwent MRI ≤24 hours after stroke onset and follow-up on day 2. WMD was scored on fluid attenuated inversion recovery MRI according to the Wahlund score. Vascular risk factors and laboratory parameters were assessed during hospital stay. Univariate and multiple logistic regression analyses were performed. Results We included 512 patients with first acute ischemic stroke[mean age,68. 5（ SD,13. 2） years]; 192 women（ 37. 5%）. In univariate analysis,age,arterial hypertension,reduced estimated glomerular filtration rate,hemoglobin A1c（ Hb A1c） levels,and female sex were associated with the presence of WMD（ P〈0. 05）. In multiple regression analysis,age,arterial hypertension,and elevated levels of Hb A1c（ P〈0. 05） remained independently associated with the extent of WMD. Conclusion Among known risk factors,higher levels of Hb A1 c were associated with cerebral WMD in stroke patients. This may suggest that chronic disturbance of glycemia measured by Hb A1 c plays a role in the pathophysiology of WMD.

关 键 词：脑白质病变 糖化血红蛋白 脑卒中 

分 类 号：R742[医药卫生—神经病学与精神病学]