急性大动脉粥样硬化性脑梗死患者糖脂代谢、HbA1c、Hcy水平与早期神经功能恶化的关系

Relationship between glucose and lipid metabolism,HbA1c,Hcy levels and early neurological deterioration in patients with acute large artery atherosclerotic cerebral infarction

目的检测急性大动脉粥样硬化性脑梗死患者糖脂代谢、糖化血红蛋白(HbA1c)、同型半胱氨酸(Hcy)水平,并分析其与早期神经功能恶化(END)的关系。方法前瞻性选取2020年4月至2023年5月天津市天津医院收治的150例急性大动脉粥样硬化性脑梗死患者展开研究,根据患者入院后END发生情况分为END组(n=32)和非END组(n=118)。比较两组患者的空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、HbA1c、Hcy水平,采用多因素Logistic回归分析急性大动脉粥样硬化性脑梗死患者发生END的危险因素。结果END组患者的FBG、LDL-C、HbA1c、Hcy分别为(8.11±1.49)mmol/L、(3.04±0.33)mmol/L、(8.02±1.36)%、(16.93±2.63)μmol/L,明显高于非END组的(6.53±1.17)mmol/L、(2.71±0.45)mmol/L、(6.38±1.21)%、(12.17±2.03)μmol/L,差异均具有统计学意义(P<0.05);多因素Logistic回归分析结果显示,FBG、LDL-C、Hb A1c、Hcy均是急性大动脉粥样硬化性脑梗死患者发生END危险因素(P<0.05)。结论急性大动脉粥样硬化性脑梗死患者的FBG、LDL-C、Hb A1c、Hcy均较高,且均是发生END的独立危险因素,临床上应予以密切关注。

Objective To detect the levels of glucose and lipid metabolism,glycosylated hemoglobin(HbA1c)and homocysteine(Hcy)in patients with acute large artery atherosclerotic cerebral infarction,and analyze their relationship with early neurological deterioration(END).Methods A total of 150 patients with acute large atherosclerotic cerebral infarction admitted to Tianjin Hospital from April 2020 to May 2023 were prospective selected.According to the occurrence of END after admission,the patients were divided into END group(n=32)and non-END group(n=118).The fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),HbA1c,and Hcy levels were compared between the two groups.Multivariate Logistic regression was used to analyze the risk factors of END in patients with acute large atherosclerotic cerebral infarction.Results The FBG,LDL-C,HbA1c,and Hcy in the END group were(8.11±1.49)mmol/L,(3.04±0.33)mmol/L,(8.02±1.36)%,and(16.93±2.63)μmol/L,which were significantly higher than(6.53±1.17)mmol/L,(2.71±0.45)mmol/L,(6.38±1.21)%,and(12.17±2.03)μmol/L in the non-END group(P<0.05).Multivariate Logistic regression analysis showed that FBG,LDL-C,HbA1c,and Hcy were all risk factors for END in patients with acute large atherosclerotic cerebral infarction(P<0.05).Conclusion FBG,LDL-C,HbA1c,and Hcy are all high in patients with acute large atherosclerotic cerebral infarction,and they are all independent risk factors for END,which should be paid close attention to clinically.