糖化血红蛋白及超敏C反应蛋白与急性脑出血患者颈动脉粥样硬化斑块的相关性

The correlation of glycosylated hemoglobin,high sensitivity C-reactive protein and carotid atherosclerotic plaque in patients with acute cerebral hemorrhage

目的探讨急性脑出血患者颈动脉斑块与超敏C反应蛋白(hs-CRP)及糖化血红蛋白(HbAlc)的相关性。方法采用颈动脉超声测量85例经CT或MRI确诊的急性脑出血患者的颈总动脉中膜厚度(IMT),并根据测量结果分为单纯急性脑出血组28例,轻度颈动脉粥样硬化组32例及重度颈动脉粥样硬化组25例,另选取同期50名健康体检者为对照组,对比分析各组hs-CRP、HbAlc水平及颈动脉斑块形成情况。结果对照组、单纯急性脑出血组、轻度颈动脉粥样硬化组及重度颈动脉粥样硬化组hs-CRP和HbAlc分别为(0.78±0.12)、(2.54±0.62)、(3.69±1.04)、(10.39±2.15)mg/L和(4.18±0.32)%、(5.32±0.45)%、(5.78±0.68)%、(6.99±0.74)%。单纯急性脑出血组hs-CRP和HbAlc水平均高于对照组(P<0.05),轻度颈动脉粥样硬化组hs-CRP和HbAlc水平均高于单纯急性脑出血组(P<0.05),而重度颈动脉粥样硬化组hs-CRP和HbAlc均高于轻度颈动脉粥样硬化组(P<0.05)。多因素Logistic回归分析显示IMT、hs-CRP、HbAlc是颈动脉粥样硬化斑块形成的独立危险因素。与其他类型斑块相比,软斑患者hs-CRP、HbAlc水平较高(P<0.05)。结论机体炎性反应水平及HbAlc异常可能是引起急性脑出血患者颈动脉粥样硬化重要因素。

Objective To investigate the correlationship between high sensitivity C-reactive protein（hsCRP）,glycosylated hemoglobin（HbAlc）and carotid atherosclerotic plaque in acute cerebral hemorrhage patients.Methods Eighty-five hospitalized acute cerebral hemorrhage patients admitted to our hospital from May2012 to March 2014 were enrolled in this study.Patients were divided into three groups including acute cerebral hemorrhage alone（n=28cases）,mild atherosclerosis（n=32cases）and severe atherosclerosis（n=25cases）groups according to carotid artery intima-media thickness（IMT）detected by carotid ultrasound,and 50 healthy samples were selected as the control group.The levels of hs-CRP and HbAlc of these groups were compared by statistics methods.Results The levels of hs-CRP [（2.54±0.62）mg/L]and HbAlc[（5.32 ± 0.45）%]of cerebral hemorrhage alone group were increased than control group [hs-CRP were（0.78±0.12）mg/L and HbAlc were（4.18±0.32）%].The levels of hs-CRP[（3.69±1.04）mg/L]and HbAlc[（5.78±0.68）%]in mild atherosclerosis group were higher than those in acute cerebral hemorrhage alone group.The levels of hsCRP [（10.39±2.15）mg/L]and HbAlc[（6.99±0.74）%]in severe atherosclerosis group were higher than those in mild atherosclerosis group,the differences were statistically significant（P 〈0.05）.The IMT,hs-CRP,HbAlc were independent risk factors for carotid atherosclerotic plaque formation.The levels of hs-CRP,HbAlc in patients with soft plaque were higher than those in patients with other types of plaque（P 〈0.05）.Conclusions Inflammatory activity and glycosylated hemoglobin abnormalities may play an important role in carotid atherosclerosis in acute cerebral hemorrhage patients.