D-二聚体和糖化血红蛋白与老年脑小血管病患者病情严重程度的关系  

Relationship between D-dimer and glycosylated hemoglobin and the degree of disease in elderly patients with small vessel diseases

作　　者：胡杰[1] 吴慧群[1] 邬甦[1] 韩亚丽 HU Jie;WU Hui-qun;WU Su;HAN Ya-li(Jiangxi Provincial People's Hospital,Nanchang 330006,China)

机构地区：[1]江西省人民医院

出　　处：《临床医学研究与实践》2019年第34期28-30,共3页Clinical Research and Practice

基　　金：江西省卫生计生委科技计划项目（No.20185025）

摘　　要：目的探讨D-二聚体(DD)和糖化血红蛋白(HbA1c)与老年脑小血管病(SVD)的关系,为老年SVD的预防及诊断提供依据。方法选取2017年1月至2018年6月在江西省人民医院收治的老年SVD患者150例。采用多普勒超声测定脑动脉脉动指数(PI),根据PI将患者分为高PI组(PI>1.5)、PI组(PI 1.2~1.5)和低PI组(PI<1.2),各50例。同时选择健康志愿者60例为健康组。四组受检者均采用免疫比浊法检测血浆DD水平,通过离子交换高效液相色谱法(HPLC)测定HbA1c水平。并比较四组受检者的血浆DD、HbA1c水平,分析DD和HbA1c水平与SVD病情严重程度的相关性。结果高PI组、PI组、低PI组及健康组的DD和HbA1c水平逐渐降低,差异均具有统计学意义(P<0.05);高PI组患者的DD和HbA1c水平均高于PI组、低PI组及健康组(P<0.05);PI组患者的DD和HbA1c水平高于低PI组及健康组(P<0.05);低PI组患者的DD和HbA1c水平高于健康组(P<0.05)。Spearman相关性分析结果显示,DD水平与SVD病情的严重程度呈正相关(r=0.955,P<0.05);HbA1c水平与SVD病情的严重程度呈正相关(r=0.984,P<0.05)。结论 DD和HbA1c水平与老年SVD呈显著正相关性,两者联合检测可有效提高SVD诊断效果,临床意义重大。Objective To investigate the relationship between D-dimer(DD) and glycosylated hemoglobin(HbA1c) in elderly patients with small vessel diseases(SVD), and to provide evidence for the prevention and diagnosis of SVD in elderly patients. Methods A total of 150 elderly patients with SVD admitted in Jiangxi Provincial People’s Hospital from January 2017 to June 2018 were selected. Pulse index(PI) of cerebral artery was measured by Doppler ultrasound,according to PI, the patients were divided into high PI group(PI>1.5), PI group(PI 1.2-1.5) and low PI group(PI<1.2),with 50 cases in each group. At the same time, 60 healthy volunteers were selected as the healthy group. The level of plasma DD was measured by immunoturbidimetry and HbA1c was measured by ion exchange high performance liquid chromatography(HPLC) in the four groups. The levels of DD and HbA1c were compared among the four groups, and the correlation between the levels of DD and HbA1c and the severity of SVD were analyzed. Results The levels of DD and HbA1c in the high PI group, the PI group, the low PI group and the healthy group decreased gradually, the differences were statistically significant(P<0.05). The levels of DD and HbA1c in the high PI group were higher than those in the PI group,the low PI group and the healthy group(P<0.05);the levels of DD and HbA1c in the PI group were higher than those in the low PI group and the healthy group(P<0.05);the levels of DD and HbA1c in the low PI group were higher than those in the healthy group(P<0.05). Spearman correlation analysis showed that the level of DD was positively correlated with the severity of SVD(r =0.955, P <0.05);the level of HbA1c was positively correlated with the severity of SVD(r =0.984, P <0.05).Conclusion The levels of DD and HbA1c are positively correlated with SVD in the elderly. The combined detection of the two indexes can effectively improve the diagnosis effect of SVD, which is of great clinical significance.

关 键 词：D-二聚体 糖化血红蛋白 老年 脑小血管疾病 

分 类 号：R446.1[医药卫生—诊断学]