2型糖尿病合并急性脑梗死患者的HbA1c水平与血清sOX40L、IL-17及预后的相关性

Correlation of HbA1c Level with Serum sOX40L,IL-17 and Prognosis in Patients wit Type 2 Diabetes Mellitush Complicated with Acute Cerebral Infarction

目的探讨2型糖尿病(T2DM)合并急性脑梗死(ACI)患者的糖化血红蛋白(HbA1c)水平与人血清可溶性OX40配体(sOX40L)、白细胞介素-17(IL-17)及其预后的相关性。方法回顾性纳入汤阴县人民医院2019年4月至2021年8月收诊的45例T2DM合并ACI患者(A组)和45例单纯T2DM患者(B组),选择同期40例健康体检者纳入C组。按照斑块性质,将A组再分为A1组(29例,不稳定斑块)和A2组(16例,稳定斑块)。比较A、B、C 3组的一般资料、血清sOX40L水平、IL-17水平、斑块指数(Crouse积分)、内-中膜厚度(IMT),比较A1、A2组血清sOX40L、IL-17水平,分析A组血清sOX40L、IL-17与HbA1c、Crouse积分、IMT的相关性。结果A、B、C 3组年龄、饮酒史、吸烟史、舒张压(DBP)水平、体质量指数(BMI)水平、总胆固醇(TC)水平比较,差异无统计学意义(P>0.05)。A组HbA1c水平高于B组,B组HbA1c水平高于C组(P<0.05);A组血清sOX40L及IL-17水平高于B组,B组血清sOX40L及IL-17水平高于C组(P<0.05);A组Crouse积分和IMT高于B组(P<0.05);A组颈动脉斑块数中不稳定斑块率高于B组(P<0.05);A1组血清sOX40L及IL-17水平高于A2组(P<0.05)。经直线相关性分析,A组患者的血清sOX40L水平与HbA1c、Crouse积分、IMT呈正相关(P<0.05),IL-17水平与HbA1c、Crouse积分、IMT也呈正相关(P<0.05)。结论血清sOX40L、IL-17水平能反映T2DM合并ACI患者的血糖水平以及颈动脉粥样斑块性质,具有良好的预后指导意义,临床可基于此做好对症干预工作。

Objective To study the correlation of glycosylated hemoglobin(HbA1c)level with serum levels of soluble OX40 ligand(sOX40L).interleukin-17(IL-17)and prognosis in patients with type 2 diabetes mellitus(T2DM)complicated with acute cerebral infarction(ACI).Methods The 45 patients with T2DM combined with ACI(A group)and 45 patients with T2DM(B group)admitted to Tangyin People’s Hospital from Apr 2019 to Aug 2021 were collected retrospectively.Another 40 healthy physical examination were selected as group C during the same period.According to the nature of plaque,patients in group A were divided into group A1(29 cases,unstable plaque)and group A2(16 cases,stable plaque).Baseline data,the serum levels of sOX40L and IL-17,plaque index(Crouse score),inner middle film thickness(IMT)were compared among A,B,C groups.Serum levels of sOX40L and IL-17 expression were compared between group A1 and group A2,and whether serum levels of sOX40L and IL-17 were related with HbA1c,Crouse score and IMT was analyzed.Results There was no statistical difference in age,drinking history,smoking history,diastolic blood pressure(DBP)level,body mass index(BMI)level and total cholesterol(TC)level among the A,B,C groups(P>0.05).The level of HbA1c in group A was higher than that in group B,and that in group B was higher than that in group C(P<0.05).Serum levels of sOX40L and IL-17 in group A were higher than those in group B,and those in group B were higher than those in group C(P<0.05).The Crouse score and IMT of group A were higher than those of group B(P<0.05).The unstable plaque rate in the number of carotid plaques in group A was higher than that in group B(P<0.05).Serum levels of sOX40L and IL-17 in group A1 were higher than those in group A2(P<0.05).According to straight-line correlation analysis,serum level of sOX40L in A group was positively correlated with HbA1c,Crouse score and IMT(P<0.05).Serum level of IL-17 in A group was positively correlated with HbA1c,Crouse score and IMT(P<0.05).Conclusion The serum levels of sOX40L and IL-17 can effectively reflect the blood glucose level and the nature of carotid atherosclerotic plaque in T2DM combined with ACI patients,and have a good prognostic significance.Based on this,clinical intervention can be done.