口服葡萄糖耐量试验2小时血糖对轻度前循环梗死患者颈动脉血流动力学的影响研究

Impact of OGTT 2-hour Post Blood Glucose on Hemodynamics of Carotid Artery in Patients with Mild Anterior Circulation Infarction

目的探讨口服葡萄糖耐量试验2小时血糖(OGTT 2 h PBG)对轻度前循环梗死患者颈动脉血流动力学的影响。方法选取2015年10月—2017年8月潍坊市人民医院神经内科收治的轻度前循环梗死患者166例,根据OGTT 2 h PBG分为糖耐量受损组91例(7.8 mmol/L≤OGTT 2 h PBG<11.1 mmol/L)和糖尿病组75例(OGTT 2 h PBG≥11.1 mmol/L);另选取同期体检健康者230例作为对照组。比较3组受试者血脂指标、空腹血糖(FPG)及颈动脉血流动力学指标,OGTT 2 h PBG与轻度前循环梗死患者颈动脉血流动力学指标的相关性分析采用Pearson相关性分析。结果 3组受试者总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05);糖尿病组患者低密度脂蛋白胆固醇(LDL-C)和FPG高于糖耐量受损组和对照组,糖耐量受损组患者FPG高于对照组(P<0.05)。糖耐量受损组和糖尿病组患者颈动脉血流剪切力、颈动脉血流峰值剪切力小于对照组,肱动脉介导的血管舒张功能(FMD)劣于对照组(P<0.05);糖尿病组患者颈动脉血流剪切力、颈动脉血流峰值剪切力小于糖耐量受损组,FMD劣于糖耐量受损组(P<0.05)。Pearson相关性分析结果显示,OGTT 2 h PBG与轻度前循环梗死患者颈动脉血流剪切力(r=-0.747)、颈动脉血流峰值剪切力(r=-0.436)及FMD(r=-0.516)呈负相关(P<0.05)。结论 OGTT 2 h PBG升高可导致轻度前循环梗死患者颈动脉血流剪切力降低,影响患者血管舒张功能。

Objective To investigate the impact of OGTT 2-hour post blood glucose（OGTT 2 h PBG） on hemodynamics of carotid artery in patients with mild anterior circulation infarction. Methods From October 2015 to August 2017, a total of 166 patients with mild anterior circulation infarction were selected in the Department of Neurology, the People＇s Hospital of Weifang, and they were divided into IGT group（with OGTT 2 h PBG equal or over 7.8 mmol/L but less than 11.1 mmol/L, n=91） and DM group（with OGTT 2 h PBG equal or over 11.1 mmol/L, n=75） according to OGTT 2 h PBG; meanwhile a total of 230 healthy volunteers admitted to this hospital for physical examination were selected as control group. Blood lipids index, FPG and hemodynamic index of carotid artery were compared in the three groups, and Pearson correlation analysis was used to analyze the correlation between OGTT 2 h PBG and hemodynamic index of carotid artery in patients with mild anterior circulation infarction. Results No statistically significant differences of TC, TG or HDL-C was found in the three groups（P〉0.05）; LDL-C and FPG in DM group were statistically significantly higher than those in IGT group and control group, FPG in IGT group was statistically significantly higher than that in control group（P〈0.05）. Carotid blood flow shear force and peak carotid blood flow shear force in IGT group and DM group were statistically significantly lower than those in control group, meanwhile FMD in IGT group and DM group was statistically significantly worse than that in control group, respectively（P〈0.05）; carotid blood flow shear force and peak carotid blood flow shear force in DM group were statistically significantly lower than those in IGT group, meanwhile FMD in DM group was statistically significantly worse than that in IGT group（P〈0.05）. Pearson correlation analysis results showed that, OGTT 2 h PBG was negatively correlated with carotid blood flow shear force（r=-0.747）, peak carotid blood flow shear force（r=-0.436） and FMD（r=-0.516）, respectively（P〈0.05）. Conclusion In patients with mild anterior circulation infarction, OGTT 2 h PBG can lead to decrease of carotid blood flow shear force, affect the flow-mediated dilation.