T2MD患者空腹血糖水平与新发缺血脑卒中的关系研究

Study on relationship between blood level of fasting glucose and new-onset of ischemic stroke in patients with type 2 MD

目的探讨2型糖尿病(T2MD)患者空腹血糖水平对新发缺血脑卒中的影响。方法以2012年6月至2014年6月收治的168例T2MD患者为研究对象,根据患者头部CT诊断结果将患者分为T2MD无缺血脑卒组(T2MD组)82例以及T2MD合并缺血脑卒中组(合并脑卒中组)86例,另选取80例正常体检者为对照组。分别测定三组体重指数(BMI)、空腹血糖值(FBG)、糖化血红蛋白(Hb A1C)、空腹胰岛素(FINS)、收缩压(SBP)、舒张压(DBP)、同型半胱氨酸(Hcy)、总胆固醇(TC)、甘油三脂(TG)、低密度脂胆固醇(LDL-C)、高密度脂胆固醇(HDL-C),并计算胰岛素抵抗指数(HOMA-IR)。空腹血糖与各指标的关系应用Pearson单因素分析,FBG与脑卒中的关系应用Logistic多因素进行分析。结果 T2MD组及合并脑卒中组BMI、FBG、Hb A1C、Hcy、FINS、HOMA-IR、TC、TG、LDL-C水平显著高于对照组(P<0.05),而HDL-C水平则低于对照组(P<0.05),其中合并脑卒中组FBG、Hb A1C、FINS、HOMA-IR、Hcy、LDL-C水平显著高于T2MD组(P<0.05)。经Pearson单因素分析可知,FBG与FINS、HOMA-IR、LDL-C呈正相关(P<0.05)。经Logistic多因素分析显示,FBG、FINS、HOMA-IR、Hcy是T2MD合并脑卒中发生的独立危险因素。结论T2MD患者空腹血糖水平与新发缺血性脑卒中关系密切,且是脑卒中存在的独立危险因子。通过控制T2MD患者空腹血糖水平可有效预防缺血性脑卒中的发生。

Objective To explore the effect of blood level of fasting glucose on new onset of ischemic stroke in patients with type 2 diabe-tes mellitus（T2MD）. Methods A total of 128 cases of T2MD during June 2012 to June 2014 were divided into T2MD without ischemic stroke group（n = 82）and T2MD complicated with ischemic stoke group（n = 86）according to their results of cerebral CT scanning,and 80 healthy per-sons were selected as control group. Body mass index（BMI）,blood levels of fasting blood glucose（FBG）,glycosylated hemoglobin（HbA1C） and fasting insulin（FINS）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,levels of homocysteine（ Hcy）,total cholesterol （TC）,triglyceride（TG）,low - density lipoprotein cholesterol（LDL - C）,high density lipoprotein cholesterol（HDL - C）,and insulin resist-ance index（HOMA - IR）were measured in patients of these groups. The correlation of plasma level of fasting glucose and respective indices were analyzed with Pearson univariate analysis. The relationship between stroke and FBG had been analyzed with Logistic multivariate analysis. Results Levels of BMI,FBG,HbA1C,Hcy,FINS,HOMA - IR,TC,TG and LDL - C in patients of T2MD group and combined stroke group were sig-nificantly higher than those of control group（ P ﹤ 0. 05）,whereas level of HDL - C was lower than that of control group（ P ﹤ 0. 05）,and levels of FBG,HbA1C,FINS,HOMA - IR,Hcy and LDL - C in patients merged with stroke group were significantly higher than those of T2MD group （ P ﹤ 0. 05）. Pearson univariate analysis showed levels of FBG,FINS,HOMA - IR and LDL - C were positively correlated（ P ﹤ 0. 05）. Logis-tic multivariate analysis showed that levels of FBG,FINS,HOMA - IR and Hcy were independent risk factors for mergence of stroke in patients with T2MD. Conclusion Level of fasting glucose in patients with T2MD is closely correlated to the new - onset of ischemic stroke,and it is an independent risk factor for occurrence of stroke in patients with T2MD. The onset of ischemic stroke can be effectively prevented by measuring blood level of fasting glucose and it can be effectively applied for prevention of the occurrence of ischemic stroke.