腔隙性脑梗死患者血糖与动脉粥样硬化的相关性研究

The relevant research into impaired glucose regulation and atherosclerosis in old age patients with lacunar infarct

目的观察腔隙性脑梗死(LI)患者合并糖尿病(DM)或血糖调节受损(IGR)时动脉粥样硬化(AS)程度的变化及影响因素。方法对2006年2月至9月于哈尔滨医科大学第一附属医院住院的经头部CT或磁共振成像(MRI)确诊为LI的83例患者进行体检并询问病史,B超检查双侧颈总动脉,观察内膜中层厚度、斑块以及内膜光滑度和连续性等。结果IGR组高血压病史、吸烟史、腰围、体重指数(BMI)、AS积分比血糖正常(NBG)组明显增高(P均<0.05),但与DM组比较差异无显著性意义。IGR组内膜光滑度和连续性明显高于NBG组,而低于DM组(P均<0.05)。与NBG组相比,IGR组AS程度与DM组相似,且与年龄、吸烟史、餐后2h血糖(2hBG)、血清胰岛素(FINS)和血尿酸(UA)质量浓度相关。结论LI患者合并DM或IGR时,加重AS的危险因素增加,应早期采取有效的治疗。

Objective To observe the relationship between impaired glucose regulation（IGR）and the degree of athero-sclerosis （AS）on Lacunar Infact （LI）patients. Methods A total of 83 patients with LI confirmed by CT or MRI were collected and divided into 3 groups by their fasting blood glucose, and their medical history and physical examination, the fasting blood lipid, acidum uricum and INI profile were evaluated with an automatic biochemistry machine. By employing a high resolution B-mode ultrasonography the intimae smoothness, intimae-media thickness （IMT） and plaque （s） were observed in bilateral common carotid arteries. Results The hypertension history, smoke history, waistline body mass index （BMI） and the atherosclerosis were all more marked in subjects with IGR than those in NGT（all P〈0.05 ） ;but quite as DM. Conclusion Subjects with IGR or DM have significant manifestation of AS as compared with subjects with NGT. AS is related to age, smoke history, glucose tolerance, INI and acidum uricum.