2型糖尿病患者血糖控制情况与颅内动脉粥样硬化斑块特征相关性的高分辨率MRI研究

Association between glycemic control and intracranial atherosclerotic plaque in patients with type 2 diabetes mellitus:a high-resolution magnetic resonance imaging study

目的:探讨2型糖尿病患者血糖控制水平和颅内动脉粥样硬化斑块特征之间的相关性。方法:回顾性将2020年4月-2022年1月在本院行颅脑高分辨率(HR)MRI检查的82例患者纳入本研究,根据临床资料分为无糖尿病组(40例)、血糖控制良好组(10例)和血糖控制不良组(32例)。基于HR-MRI图像,测量每例患者颅内动脉最狭窄处斑块的长度、厚度和管腔狭窄率,并采用Kruskal-Wallis检验比较3组之间上述指标的差异。分别按照颅内动脉最狭窄处斑块的长度、厚度及管腔狭窄率的中位数,将82例患者分成两组,采用logistic回归模型分析颅内动脉粥样硬化斑块长度、厚度及管腔狭窄率的临床危险因素。结果:无糖尿病组、血糖控制良好组及血糖控制不良组之间颅内动脉粥样硬化斑块长度的差异有统计学意义(H=21.454,P<0.001);三组之间颅内动脉粥样硬化斑块厚度和管腔狭窄率的差异均无统计学意义(P>0.05)。多因素logistic回归分析显示,血糖控制不良是颅内动脉粥样硬化斑块长度的独立风险因素(OR=1.98,95%CI:1.15~3.41,P=0.013),甘油三酯升高是颅内动脉粥样硬化斑块厚度和管腔狭窄率的独立风险因素(OR=3.36,95%CI:1.27~8.89,P=0.014;OR=4.04,95%CI:1.48~10.99,P=0.006)。结论:2型糖尿病患者血糖控制情况与颅内动脉粥样硬化斑块特征之间有一定的相关性,HR-MRI可以帮助我们更好的了解血糖控制不良与颅内动脉粥样硬化斑块特征的关系。

Objective:To investigate the association between glycemic control extension and the characteristics of intracranial atherosclerotic plaque in patients with type 2 diabetes mellitus.Methods:Eighty-two patients who underwent cranial high-resolution magnetic resonance(HR-MRI) examinations at our Hospital from April 2020 to January 2022 were retrospectively included in this study.According to clinical data,the patients were divided into non-type 2 diabetes mellitus group(n=40),type 2 diabetes mellitus with good glycemic control group(n=10) and type 2 diabetes mellitus with poor glycemic control group(n=32).The length and thickness of the plaque and the lumen stenosis rate at the most stenotic point of intracranial artery were measured based on HR-MRI images,the Kruskal-Wallis test was used to compare the differences of the three indexes mentioned above among the three groups.The patients were divided into two groups according to the medians of plaque length,thickness and lumen stenosis rate at the most stenotic point of intracranial artery respectively,and then logistic regression analysis was used to analyze the clinical risk factors of the three indexes.Results:There was statistically significant difference in intracranial plaque length among the three groups(H=21.454,P0.05).Multivariate logistic regression analysis showed that poor blood glucose control was an independent risk factor for the length of intracranial atherosclerotic plaques(OR=1.98,95%CI:1.15~3.41,P=0.013),and elevated triglyceride was an independent risk factor for intracranial atherosclerotic plaque thickness and luminal stenosis rate(OR=3.36,95%CI:1.27~8.89,P=0.014;OR=4.04,95%CI:1.48~10.99,P=0.006).Conclusion:There is a certain correlation between glycemic control and intracranial atherosclerotic plaque characteristics in patients with type 2 diabetes.HR-MRI can help us better understand the relationship between poor glycemic control and the characteristics of intracranial atherosclerotic plaques.