糖尿病并发脑梗死的风险因素及定量分析研究

The Risk Factors and Quantitative Analysis of Diabetes Mellitus Complicated with Cerebral Infarction

目的:分析研究糖尿病并发脑梗死的风险因素及价值。方法:回顾性分析河南大学第一附属医院收治的150例糖尿病患者临床资料,根据是否合并脑梗死分为糖尿病组130例,糖尿病并发脑梗死组20例。比较两组患者性别、年龄、病程、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及高迁移率族蛋白B1(HMGB1)指数,采用logistic多因素分析糖尿病并发脑梗死的风险因素,分析相关因素判断脑梗死的价值。结果:单因素分析显示糖尿病合并脑梗死组年龄、病程、SBP、DBP、血清FBG、HbAlc、TG、TC、LDL-C、HMGB1水平均显著高于糖尿病组,差异有统计学意义(t=5.366、5.318、4.716、4.075、2.180、3.329、4.129、17.443、10.803、70.005,P<0.05),HDL-C水平显著低于糖尿病组,差异有统计学意义(t=7.393,P<0.05)。多因素分析显示血清HbAlc、TC、LDL-C及HMGB1均为糖尿病并发脑梗死的独立影响因素,差异有统计学意义(P<0.05),HMGB1判断糖尿病并发脑梗死的AUC为0.846(95%CI=0.766~0.925,P=0.000)。结论:糖尿病并发脑梗死与血清HbAlc、TC、LDL-C及HMGB1密切相关,监测HMGB1水平有助于判断糖尿病患者继发脑梗死风险。

Objective:To study the risk factors and quantitative analysis of diabetes mellitus complicated with cerebral infarction.Methods:The clinical data of 150 diabetic patients were analyzed retrospectively.According to whether complicated with cerebral infarction or not,they were divided into diabetes group with 130 cases and diabetes complicated with cerebral infarction group with 20 cases.Gender,age,disease duration,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),glycosylated hemoglobin(HbAlc),triacylglycerol(TG),total cholesterol(TC),high-density lipids,protein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and high mobility group B1(HMGB1)index were compared between the two groups.Logistic multivariate analysis was used to analyze the risk factors of diabetes complicated with cerebral infarction,and the related factors were analyzed to determine the value of cerebral infarction.Results:Univariate analysis showed that the age,disease course,SBP,DBP,serum FBG,HbAlc,TG,TC,LDL-C,and HMGB1 levels in the diabetes complicated with cerebral infarction group were significantly higher than those in the diabetes group,and the difference was statistically significant(t=5.366,5.318,4.716,4.075,2.180,3.329,4.129,17.443,10.803,70.005,P<0.05).The level of HDL-C was significantly lower than that in the diabetes group,and the difference was statistically significant(t=7.393,P<0.05).Multivariate analysis showed that serum HbAlc,TC,LDL-C and HMGB1 were independent influencing factors of diabetes complicated with cerebral infarction,and the difference was statistically significant(P<0.05).The AUC of HMGB1 for judging diabetes complicated with cerebral infarction was0.846(95%CI=0.766-0.925,P=0.000).Conclusion:The diabetes mellitus complicated with cerebral infarction is closely related to serum Hb Alc,TC,LDL-C and HMGB1.Monitoring the level of HMGB1 is helpful to judge the risk of secondary cerebral infarction in diabetic patients.