HbA1c水平与脑出血合并糖尿病患者迟发性脑水肿的相关性研究

Correlation of HbA1c value with severity of delayed cerebral edema in patients with ICH complicated with diabetes

目的探讨HbA1c水平与脑出血合并糖尿病患者迟发性脑水肿的相关性。方法回顾性分析115例于唐山市工人医院神经外科住院的脑出血合并糖尿病患者。采用HPLC法检测HbA1c,根据HbA1c水平分为HbA1c<7.0%组(A组)、7.0%~9.0%组(B组)和HbA1c>9.0%组(C组),分析HbA1c水平对脑出血合并糖尿病患者迟发性脑水肿的影响。结果 3组迟发性脑水肿发生率差异有统计学意义(P<0.05);脑出血合并糖尿病发生迟发性脑水肿患者水肿体积与HbA1c(r=0.814,P=0.000)、GCS评分(r=-0.780,P=0.000)、NIHSS评分(r=0.696,P=0.000)均相关;多元线性回归分析后,HbA1c与患者水肿体积仍相关(β=0.741,t=5.280,P=0.000)。结论 HbA1c水平与脑出血合并糖尿病患者迟发性脑水肿严重程度相关。

Objective To explore the correlation between glycated hemoglobin Alc （HbAlc） value and the severity of delayed cerebral edema in patients with intracerebral hemorrhage （ICH） complicated with diabetes. Methods A total of 115 patients of ICH complicated with diabetes hospitalized in Tangshan Gongren Hospital were retrospectively analyzed and divided into three groups： group A （HbAlc 〈 7.0%）, group B （7.0%≤ HbAlc 9.0%）, and group C （HbAlc 〉 9.0%） according to HbAlc level. High-pressure liquid chromatography （HPLC） was adopted to detect HbAlc. Glasgow Coma Scale （GCS） and the US National Institutes of Health Stroke Scale （NIHSS） were used to assess patients＂ condition. Then the influence of HbAlc on delayed cerebral edema in the ICH patients was analyzed. Results The incidence of delayed cerebral edema was significant different among the three groups （all P 〈 0.05）. Edema volume of the patients with delayed cerebral edema was correlated with HbAlc, GCS and NIHSS score （r = 0.814, -0.780 and 0.696 respectively; all P = 0.000）. Furthermore, HbAlc level was still correlated with the edema volume in multiple linear regression analysis （β = 0.741, t = 5.280, P = 0.000）. Conclusions HbAlc level is correlated with the severity of delayed cerebral edema in patients with intracerebral hemorrhage complicated with diabetes.