2型糖尿病并发急性脑梗死的血脂水平及颈动脉超声检测研究

Clinical value of carotid ultrasound and blood lipid level in type 2 diabetic patients with acute cerebral infarction

目的探讨2型糖尿病患者发生急性脑梗死时的血脂水平及颈动脉超声检查的意义。方法回顾性收集急性脑梗死患者136例,根据是否为2型糖尿病患者分为糖尿病脑梗死组70例和非糖尿病脑梗死组66例,同期住院的未发生急性脑梗死的糖尿病患者70例为糖尿病对照组。采集血清总胆固醇(TCHOL)、甘油三酯(TG)、空腹血糖(GLU)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(apoA)、载脂蛋白B(apoB)及颈动脉超声检查结果,进行统计学分析。结果 1空腹GLU、TG、apoB、LDL-C、TCHOL血清浓度糖尿病脑梗死组高于非糖尿病脑梗死组及糖尿病对照组(P<0.05)。糖尿病脑梗死组患者血清HDL-C浓度显著低于糖尿病对照组(P<0.01)。2颈动脉粥样硬化斑块发生率三组间无统计学差异,三组双侧颈动脉斑块发生率分别为63.46%,70.77%,82.46%。3糖尿病脑梗死组颈动脉粥样硬化最大斑块面积高于糖尿病对照组(P<0.05)。结论与非糖尿病脑梗死及糖尿病对照组相比,糖尿病脑梗死患者存在明显的血脂异常。颈动脉超声检查和血脂检测在糖尿病患者的脑卒中预防方面具有一定的临床价值。

Objective To explore the significance of carotid ultrasound and the blood lipid level in type 2 diabetic patients with acute cerebral infarction.Methods Totally 136 cases of acute cerebral infarction（ACI） were enrolled retrospectively,including 70 cases of ACI with type 2 diabetes mellitus （ACI-DM group） and 66 cases of ACI without diabetes（ACI group）.Seventy type 2 diabetic inpatients without acute cerebral infarction were enrolled as DM group.The serum concentration of total cholesterol（TCHOL）,triglyceride （TG）,fasting glucose （GLU）,low density lipoprotein cholesterol （LDL-C）,high density lipoprotein cholesterol （HDL-C）,apolipoprotein A（apoA） and apolipoprotein B （apoB） were detected.The results of carotid ultrasound were collected and compared among three groups.Results The serum concentrations of TG,GLU,apoB,LDL-C and TCHOL were significantly higher in ACI-DM group than those in the other groups （P ＜ 0.05）,while the serum concentration of HDL-C was lower in ACI-DM group than those in DM group （P ＜ 0.01）.The positive rate of carotid artery plaque was not different among three groups,and the positive rate of bilateral carotid artery plaques was 63.46％,70.77％,82.46％,respectively.The plaque square in ACI-DM group was significantly larger than those in DM group（P ＜ 0.05）.Conclusion Compared with control patients,type 2 diabetic patients have distinct dyslipidemia when they are suffering from acute cerebral infarction.Carotid ultrasound and blood lipid detection can provide somewhat clinical value in preventing the stroke in diabetic patients.