缺血性卒中病人的血液流变学和血糖水平相关性研究

Correlation between Hemorheological Properties and Blood Glucose Level in Ischemic Stroke

目的 了解缺血性卒中病人血液流变性和血糖水平间的关系。方法 对 96例缺血性脑卒中病人进行血糖和血流变学相关参数的检测。结果 缺血性卒中病人的全血高切、中切、低切黏度 ,血浆黏度 ,红细胞聚集指数 ,红细胞变形指数 ,均较正常对照组增高 (P <0 .0 5 ) ,其中全血中切、低切黏度、血浆黏度与糖化血红蛋白正相关 (P <0 .0 5 ) ,红细胞变形指数与空腹血糖、糖化血清蛋白和糖化血红蛋白正相关 (P <0 .0 5 ) ,红细胞聚集指数与糖化血红蛋白和糖化血清蛋白正相关 (P <0 .0 5 )。调整红细胞聚集和变形指数、血浆黏度、红细胞压积、纤维蛋白原含量后计算血糖和全血黏度之间的偏相关系数 ,发现全血中切、低切黏度与糖化血红蛋白、糖化血清蛋白和血糖正相关 (P <0 .0 1)。结论 缺血性卒中病人血液流变学的异常改变与血糖增高有关 ,高血糖主要通过影响红细胞聚集和变形能力、血浆黏度 ,使全血黏度升高 ,长期高血糖和反应性高血糖均可影响缺血性卒中病人的血流变性指标。

Objective The aim of this study is to investigate the correlation between hemorheological properties and blood glucose level in ischemic stroke.Methods The relative parameters of hemorheology and blood glucose were measured in 96 patients.Result The whole blood visosity at low, middle and high shear rate,plasma viscosity,aggregability and deformability index of erythrocyte in ischemic stroke were significantly higher (P<0.05) than that in controls.The middle and low shear rate whole blood viscosity and plasma viscosity were positively correlated(P<0.05) with haemoglobin ALC (HbAlc).The deformability index of erythrocyte was positively correlated (P<0.05) with fasting blood glucose (FBG),fructosamine and HbAlc.After the aggregability and deformability index of erythrocyte,plasma viscosity,haematocrit and fibrinogen being controlled,the who1e blood viscosity at middle and low shear rate were positively correlated (P<0.01) with HbAlc,fructosamine and FBG.Conclusion Our study indicates that the disturbances of hemorheology is related with hyperglycemia in ischemic stroke,that hyperglycemia results in the elevated whole blood viscosity by impairing the aggregability and deformability of erythrocyte and plasma viscosity,and that the stress,as well as chronic,hyperglycemia may lead to the impairment of hemorheology in ischemic stroke.