糖耐量异常对急性脑梗死患者血浆Hcy和血清hs-CRP水平的影响

The Influence of Abnormal Glucose Tolerance on the Levels of Plasma Homocysteine and Serum High-sensitivity C-reactive Protein in Patients with Acute Cerebral Infarction(ACI)

目的:观察糖耐量异常对急性脑梗死(acute cerebral infarction,ACI)患者的同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)水平的影响。方法:756例ACI患者按葡萄糖耐量试验(OGTT)结果分为糖耐量正常组(NGT,331例)、单纯性糖耐量异常组(IGT,142例)、2型糖尿病组(DM2,283例)。在入院24h之内测定血清Hcy、hs-CRP水平并进行组间比较。结果:IGT组及DM2组的Hcy水平(19.17±9.35)μmol/L、(20.46±10.56)μmol/L以及hs-CRP水平(8.0±2.9)mg/L、(7.7±2.3)mg/L明显高于NGT组(16.17±7.35)μmol/L、(3.5±1.2)mg/L。IGT组及DM2组两组之间的Hcy、hs-CRP水平差异均无统计学意义(P>0.05、P>0.05)。结论:单纯性糖耐量异常的ACI患者血清Hcy、hs-CRP水平明显升高,表明在糖耐量异常阶段,已经出现了慢性低水平炎症和动脉粥样硬化的发生。提示糖耐量异常和糖尿病一样可引起动脉粥样硬化,OGTT试验应常规作为ACI危险因素的筛查指标,以利于ACI的预防。

Objective To observe the influence of abnormal glucose tolerance on the levels of homocysteine and high-sensitivity C-reactive protein in patients with acute cerebral infarction（ACI）.Methods 756 patients with ACI were divided into normal glucose tolerance group（NGT,331cases）,abnormal glucose tolerance group（IGT,142cases）,and diabetes mellitus group（DM,283scase） according to the result of oral glucose tolerance test（OGTT）.The serum levels of Hcy and hs-CRP were measured in 24 hours after admission.Result The both levels of Hcy and hs-CRP in IGT group（19.17±9.35μmol/L,20.46±10.56 μmol/L） and DM group（8.0±2.9 mg/L,7.7±2.3 mg/L）were higher than the NGT group with no difference between each other.Conclusion The levels of Hcy and hs-CRP in patients with ACI and abnormal glucose tolerance rise significantly,which indicate the presence of chronic low-grade inflammation and atherosclerosis in the stage of abnormal glucose tolerance.The results showed abnormal glucose tolerance is the risk factor of atherosclerosis as diabetes mellitus,and the OGTT test is valuable in screening risk factors of ACI and stroke prevention.