糖化血红蛋白在非糖尿病性无症状性脑梗死患者危险因素检测中的临床意义

Clinical significance of glycosylated hemoglobin in the detection of risk factors of non diabetic asymptomatic cerebral infarction

目的了解糖化血红蛋白(HbA1c)、同型半胱氨酸(Hcy)等因素与非糖尿病性无症状性脑梗死的关系。方法选择140例门诊患者,通过头颅CT或MRI检查,将其分为无症状性脑梗死组和对照组;根据无症状性脑梗死的梗死部位及梗死灶的多少进行分类;对所有入选者随访1年,终点事件为症状性脑梗死,对其均检测HbA1c、Hcy、血糖、血脂、尿酸等。结果非糖尿病性无症状性脑梗死者TC、LDL、HbA1c、Hcy较正常组高,差异有统计学意义(P<0.01);TC、HbAlc、LDL、Hcy水平于基底核组高于其他部位组(P<0.01);HbA1c在多病灶组水平高于单病灶组,差异有统计学意义(P<0.05)。多元Logistic回归分析提示HbAlc是无症状性梗死的独立危险因素,且为再发症状性脑梗死的独立危险因素。结论 HbA1c为非糖尿病性无症状性脑梗死的危险因素之一,监测HbA1c有助于早期发现无症状性脑梗死,通过降低其水平,可减少无症状性脑梗死的风险以及防止其进展有重要意义,可为脑血管病的预防和治疗提供一个新途径。

Objective To investigate the relationship between glycosylated hemoglobin(HbA1c),homocysteine(Hcy)and other factors in patients with asymptomatic cerebral infarction.Method A total of140patients undergoing head CT or MRI.Patients were divided into asymptomatic cerebral infarction group and controlgroup.All patients were classified according to how much of myocardial infarction and infarction of asymptomaticcerebral infarction.All patients were followed up for1years,Who were detected in HbA1c,Hcy,blood glucose,bloodlipid and uric acid ect.Endpoints were symptomatic cerebral infarction.Results The level of TC,LDL,HbA1c,Hcyin non diabetic asymptomatic cerebral infarction is higher than the normal group,with statistical significance(P<0.01).The level of TC,HbAlc,LDL and Hcy in the basal ganglia group is higher than that of other parts(P<0.01).The levelof HbA1c in multiple group was higher than that of single lesion group,with statistical significance(P<0.05).MultipleLogistic regression analysis suggested that HbAlc was an independent risk factor for asymptomatic infarction,and wasan independent risk factor for recurrent symptomatic cerebral infarction.Conclusion HbA1c is one of the risk factorsof non diabetic asymptomatic cerebral infarction,HbA1c monitoring is helpful in the early diagnosis of asymptomaticcerebral infarction.The risk of asymptomatic cerebral infarction can be reduced through lowering its level.It shall be anew way for prevention and treatment of cerebrovascular disease.