2型糖尿病患者血糖波动性与初发急性脑梗死的相关性

The correlation of type 2 diabetes mellitus concomitant with acute cerebral infarction with glucose fluctuation

目的研究2型糖尿病患者血糖波动性(空腹血糖变异系数)与初发急性脑梗死的相关性。方法选取2型糖尿病合并急性脑梗死患者106例为实验组,无脑梗死2型糖尿病患者55例为对照组,记录住院期间前2周空腹末梢血糖值,据此计算空腹血糖变异系数(CV),将急性脑梗死组分为血糖平稳组(CV<0.29)及波动性高血糖组(CV≥0.29),监测相关实验室指标,进行统计学分析。结果(1)急性脑梗死组空腹血糖变异系数水平较对照组升高,差异有统计学意义(P<0.05)。(2)急性脑梗死组中,波动性高血糖组以大梗死为多,血糖平稳组以腔隙性梗死为主,差异均有统计学意义(P<0.05)。(3)急性脑梗死组中,血糖平稳亚组与波动性高血糖亚组入院时及治疗后的神经功能缺损程度比较,差异有统计学意义(P<0.05)。血糖平稳组入院时与治疗2周后NIHSS评分比较差异有统计学意义(P<0.001),波动性高血糖组入院时与治疗2周后NIHSS评分比较差异无统计学意义(P=0.132)。结论空腹血糖变异系数升高是2型糖尿病合并急性脑梗死的危险因素。减少血糖波动,可延缓病程进展,改善预后。

Objective To investigate the relationship between type 2 diabetes mellitus（T2DM）accompamed with acute cerebral infarction and glucose fluctuation. Methods We selected 106 T2DM patients with acute cerebral infarction as experimental group and 55 T2DM without cerebral infarction as control group. Then we recorded the fasting peripheral blood glucose values during the first two weeks of hospitalization stays and calculated variable coefficient of fasting blood glucose（FPG-VC）. According to FPG-VC value, patients in the experimental group were grouped into blood glucose stable group（CV〈0.29） and fluctuating hyperglycemia group（CV≥0.29）whose laboratory data were recorded and analyzed. Results The FPG-VC value in the experimental group was significantly higher than that in the control group. In the experimental group, the fluctuating hyperglycemia group mainly presented large-size infarction while the blood glucose stable group primarily showed lacunar infarction, and the difference was significant. As for the degree of neurological deficit（NHISS scores）among the experimental group both on admission and after treatment, the statistical differences were found between blood glucose stable group and fluctua- ting hyperglycemia group, and after treatment the blood glucose stable group indicated statistical difference compared with that on admission while the fluctuating hyperglycemia group showed no difference. Conclusion The FPG-CV vale is one of the risk factors of type 2 diabetes mellitus（T2DM）accompanied with acute cerebral infarction. The progress can be delayed and prognosis can be improved by reducing glucose excursion.