2型糖尿病合并脑梗死患者血糖水平与PSGL-1的关系及其意义

目的 探讨老年2型糖尿病合并脑梗死患者血糖水平对P-选择素糖蛋白配体1(PSGL-1)表达的影响及其意义。方法 选择70~80岁的住院患者120例，分为3组：2型糖尿病合并急性脑梗死组(DMCI组)、单纯急性脑梗死组(CI组)、单纯2型糖尿病组(DM组)，每组40例，以健康查体者40例为健康对照组(NC组)。用流式细胞仪检测PSGL-1的表达量，常规生化检测糖化血红蛋白、空腹血糖、早餐后2h血糖水平，并对脑梗死患者采用美国国立卫生研究院卒中量表(NIHSS)进行评分。结果 DMCI组、DM组、CI组PSGL-1的表达量(44.57±6.07、41.03±4.34、42.25±4.85)与NC组(33.12±3.72)相比，差异均有统计学意义(P均＜0.05)。相关分析显示，PSGL-1的表达与糖化血红蛋白(r=0.72， P＜0.01)、餐后血糖(r=0.36， P＜0.05)、空腹血糖(r=0.19， P＜0.05)均呈显著正相关。结论 PSGL-1的表达在2型糖尿病合并脑梗死患者中显著增高。血糖水平可以影响PSGL-1的表达，PSGL-1可能是2型糖尿病合并脑梗死患者的一个高危因素且与病情有明显相关性。

Relationship between blood glucose level and PSGL-1 expression in acute cerebral infarction patients with type 2 diabetes mellitus and its significance

Objective To explore the influence and significance of blood glucose level on PSGL-1 expression in acute cerebral infarction patients with type 2 diabetes mellitus. Methods One hundred and twenty subjects who were 70 to 80 years old were divided evenly into 3 groups: acute cerebral infarction with type 2 diabetes mellitus group(DMCI group), acute cerebral infarction group(CI group), diabetes group(DM group). Forty people who had a physical examination were taken as healthy control group(NC group). Flow cytometry was used to measure the expression of PSGL-1. The levels of glycosylated haemoglobin A1c, fasting plasma glucose and postprandial blood glucose were detected by conventional biochemical tests. NIHSS scores of all the acute cerebral infarction patients were judged when they were enrolled into hospital. Results The levels of PSGL-1 in DMCI group (44.57±6.07), DM group(41.03±4.34) and CI group(42.25±4.85) were significantly higher than that in NC group (33.12±3.72)(all P<0.05). The level of PSGL-1 was positively related with glycosylated haemoglobin A1c(r=0.72, P<0.01), postprandial blood sugar(r=0.36, P<0.05) and fasting plasma glucose(r=0.19, P<0.05). Conclusion The level of PSGL-1 increases significantly in acute cerebral infarction patients with type 2 diabetes mellitus. There are significant correlations between PSGL-1 and blood glucose levels. PSGL-1 could be a high risk factor in acute cerebral infarction of patients with type 2 diabetes mellitus and significantly relates to the changes of patients′condition.