急性脑梗死合并糖尿病患者颈动脉斑块内新生血管与糖化血红蛋白的相关性研究  

Study on correlation between intraplaque neovascularization and glycosylated hemoglobin in patients with acute cerebral infarction and diabetes

作　　者：苏前[1] 周剑锋 皮永前[2] 何欢 李辉碧 吕芳 SU Qian;ZHOU Jianfeng;PI Yongqian;HE Huan;LI Huibi;LYU Fang(Department of Neurology,Liutie Central Hospital of Liuzhou,Liuzhou 545007,Guangxi,China;Department of Ultrasound,Liutie Central Hospital of Liuzhou,Liuzhou 545007,Guangxi,China)

机构地区：[1]广西柳州市柳铁中心医院神经内科,广西柳州545007 [2]广西柳州市柳铁中心医院超声科,广西柳州545007

出　　处：《右江医学》2024年第3期227-233,共7页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190196)。

摘　　要：目的探讨急性脑梗死(ACI)合并2型糖尿病(T2DM)患者颈动脉斑块内新生血管(IPN)与糖化血红蛋白(HbA1c)的相关性。方法纳入135例ACI患者,其中合并T2DM 68例(合并组),单纯ACI 67例(单纯组)。比较两组HbA1c、空腹血糖(FBG)等生化指标水平、常规超声及超声造影IPN分级;根据HbA1c水平分层,比较并分析IPN分级与HbA1c的关系。结果合并组血清HbA1c、FBG和同型半胱氨酸(Hcy)水平均高于单纯组(P<0.01或0.05),不稳定斑块及Ⅲ/Ⅳ级IPN的检出率均高于单纯组(P<0.05)。合并组中血清HbA1c>6.5%水平患者48例,HbA1c≤6.5%水平患者20例,前者不稳定斑块的检出率高于后者(P<0.05)。合并组Ⅲ/Ⅳ级IPN患者的HbA1c水平高于Ⅰ/Ⅱ级IPN患者(P<0.05);HbA1c水平与IPN分级呈正相关(r=0.346,P<0.05)。结论急性脑梗死合并2型糖尿病患者颈动脉斑块内新生血管分级与糖化血红蛋白水平有相关性,有助于识别斑块易损性。Objective To explore correlation between intraplaque neovascularization(IPN)and glycated hemoglobin(HbA1c)in patients with acute cerebral infarction(ACI)and type 2 diabetes(T2DM).Methods 135 patients with ACI were included,including 68 patients with T2DM(combined group)and 67 patients with ACI alone(simple group).The levels of biochemical indicators such as HbA1c and fasting blood glucose(FBG)as well as conventional ultrasound and contrast-enhanced ultrasound IPN grading between the two groups were compared.And relationship between IPN grading and HbA1c levels were compared and analyzed according to the stratification of HbA1c levels.Results Serum HbA1c,FBG,and homocysteine(Hcy)levels in the combined group were higher than those in the simple group(P<0.01 or 0.05),and the detection rates of unstable plaques and gradeⅢ/ⅣIPN were higher than those in the simple group(P<0.05).There were 48 patients with serum HbA1c levels>6.5%and 20 patients with HbA1c levels≤6.5%in the combined group.The detection rate of unstable plaques in the former was higher than that in the latter(P<0.05).In the combined group,the HbA1c levels in patients with gradeⅢ/ⅣIPN were higher than those in patients with gradeⅠ/ⅡIPN(P<0.05),and HbA1c levels were positively correlated with IPN grading(r=0.346,P<0.05).Conclusion There is a correlation between IPN grading and HbA1c levels in patients with acute cerebral infarction and diabetes mellitus,which is helpful to identify plaque vulnerability.

关 键 词：急性脑梗死 斑块内新生血管 颈动脉粥样硬化 糖化血红蛋白 

分 类 号：R587.1[医药卫生—内分泌] R743.33[医药卫生—内科学]