血清残余胆固醇和HbA1c水平与2型糖尿病合并急性脑梗死相关性分析  

An analysis of correlation between serum residual cholesterol and HbAlc levels and acute cerebral infarction in patients with type 2 diabetes mellitus

作　　者：郝志超 华芸芸 孙佳欣 王雪鹰[2] HAO Zhichao;HUA Yunyun;SUN Jiaxin(Graduate Training Base,Jinzhou Medical University,Jinzhou Central Hospital,Jinzhou 121000,CHINA)

机构地区：[1]锦州医科大学锦州市中心医院研究生培养基地,辽宁121000 [2]锦州市中心医院内分泌科

出　　处：《江苏医药》2023年第7期709-713,共5页Jiangsu Medical Journal

摘　　要：目的探讨血清残余胆固醇(RC)和HbA1c水平与2型糖尿病(T2DM)合并急性脑梗死(ACI)的相关性。方法回顾性分析100例T2DM合并ACI患者(T2DM+ACI组)和100例T2DM未合并ACI患者(T2DM组)的临床资料。比较两组患者一般资料及生化检测结果。采用多因素logistic回归分析T2DM合并ACI的危险因素。将T2DM+ACI组分为轻度组[美国国立卫生研究院卒中量表(NIHSS)评分<5分,50例]、中度组(5分≤NIHSS评分≤15分,31例)和重度组(NIHSS评分>15分,19例)三个亚组,比较三组RC和HbA1c水平。绘制ROC曲线评估RC和HbA1c对T2DM合并ACI的诊断价值。结果T2DM+ACI组患者年龄、高血压患者比例及HbA1c、TC、LDL-C、RC水平均高于T2DM组,而HDL-C水平低于T2DM组(P<0.05)。多因素logistic回归分析结果显示,年龄越大、高RC水平和高HbA1c水平是T2DM患者合并ACI的独立危险因素(P<0.05)。重度组RC和HbA1c水平高于轻、中度组(P<0.05),中度组RC和HbA1c水平亦高于轻度组(P<0.05)。Spearman相关分析结果显示,T2DM+ACI组RC、HbA1c水平与NIHSS评分均呈正相关(r_(s)=0.714、0.696,P<0.05)。ROC曲线分析结果显示,RC、HbA1c诊断T2DM患者合并ACI的AUC分别为0.904[95%CI(0.864~0.943),P<0.01]、0.697[95%CI(0.626~0.769),P<0.01],取最佳诊断界值分别为2.30 mmol/L、7.40%时,对应的诊断灵敏度分别为89%、95%,特异度分别为75%、33%。结论血清RC和HbA1c水平与T2DM患者合并ACI密切相关,且两者均与脑神经功能缺损程度呈正相关。Objective To analyze the correlation between serum residual cholesterol(RC)and HbAlc levels and acute cerebral infarction(ACI)in the patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 100 T2DM patients with ACI(T2DM+ACI group)and 100 T2DM patients without ACI(T2DM group)were retrospectively analyzed.The general information and biochemical test results were compared between the two groups.Multivariate logistic regression analysis was used to investigate the risk factors for T2DM combined with ACI.The patients with T2DM and ACI were divided into mild group(NIHSS score<5 points,50 cases),moderate group(5 points≤NIHSS score≤15 points,31 cases),and severe group(NIHSS score>15 points,19 cases).The levels of RC and HbAlc were compared among the three groups.The ROC curve was drawn to evaluate the diagnostic value of RC and HbAlc for T2DM combined with ACI ResultsThe age,hypertension proportion,HbAlc,TC,LDL-C and RC levels were higher,while HDL-C levels was lower in T2DM+ACI group than those in T2DM group(P<0.05).The results of multivariate logistic regression analysis showed that older age,higher RC level and higher HbAlc level were the independent risk factors for T2DM patients combined with ACI(P<0.05).The RC and HbAlc levels in severe group were higher than those in mild and moderate groups(P<0.05),and the levels of which in moderate group were higher than those in mild group(P<0.05).Spearman correlation analysis showed that the levels of RC and HbAlc in T2DM+ACI group were positively correlated with the NIHSS score(r_(s)=0.714,0.696,P<0.05).The results of ROC curve analysis showed that the AUC values of RC and HbAlc for diagnosing T2DM patients combined with ACI were 0.904[95%CI(0.864-0.943),P<0.01]and 0.697[95%CI(0.626-0.769),P<0.01],respectively.Taking 2.30 mmol/L and 7.40%as the optimal diagnostic cut-off values of RC and HbAlc,the sensitivity and specificity of the diagnosis were 89%,95%and 75%,33%,respectively.Conclusion Serum RC and HbAlc levels are closely associated with the develo

关 键 词：2型糖尿病 急性脑梗死 残余胆固醇 糖化血红蛋白 

分 类 号：R587[医药卫生—内分泌]