糖化血红蛋白与急性脑梗死发病关系的临床研究

目的 探讨急性脑梗死患者与正常对照组糖化血红蛋白(HbA1c)含量的差异,脑梗死患者HbA1c含量与其神经功能缺损程度评分的相关性以及影像学中脑梗死病灶数与HbA1c含量间的关系.方法 选取186例发病1周内的急性脑梗死患者,入院后行神经功能缺损程度评分,人院24 h内空腹查FibAlc,发病或病情稳定48 h后查颅脑MRI,脑梗死恢复期行葡萄糖耐量检查.同时对160名健康体检者抽空腹血查HbA1c、行葡萄糖耐量实验.观察脑梗死患者与健康体检者HbA1c水平的差异.脑梗死患者HbA1c含量与其神经功能缺损程度评分的相关性以及HbA1c含量与脑梗死病灶个数的关系.结果急性脑梗死患者HbA1c水平(6.982%±1.803%)较对照组(5.128%±0.592%)增高,比较差异有统计学意义(P<0.05);脑梗死患者血中HbA1c含量与其神经功能缺损程度评分呈正相关(r=0.760,P<0.05);2个脑梗死病灶组HbA1c含量(6.635%±0.427%)与1个病灶组(5.803%±0_307%)比较差异有统计学意义(P<0.05),3个及3个以上病灶组HbA1c含量(8.571%±0.519%)分别与1个病灶组、2个病灶组比较差异有统计学意义(P<0.05).结论 糖尿病是脑梗死的重要危险因素,较高水平的HbA1c引起的一系列脑血管病理改变是脑梗死事件发生的重要冈素.HbA1c水平也是早期对病情严重程度评估的一个重要指标,积极控制高血糖、降低HbA1c水平有助于减少脑梗死事件的发生.

Relation between glycosylated hemoglobin and acute cerebral infarction

Objective To investigate the differences of blood glycosylated hemoglobin (HbA1c) levels between the patients with acute cerebral infarction and healthy controls, and explore the relation between HbA1c level and both neurological deficits scores and imaging of lesions in number. Methods One hundred and eighty-six patients with acute cerebral infarction within 1 week were performed neurological deficits scales after the admission; the HbA1c level was measured within 24 h admission; brain MRI scan was performed on these patients 48 h after onset or stabilization. Glucose tolerance test was taken at the rehabilitation of infarction (except for having a clear history of diabetes before). At the same time, 160 healthy controls were checked on the level of HbA1c and taken the glucose tolerance test. The differences of blood HbA1c levels between the patients with acute cerebral infarction and healthy controls were investigated; and the relation between HbA1c level and both neurological deficits scores and imaging of lesions in number was explored. Results The HbA1c level in patients with acute cerebral infarction (6.982%±1.803%) was significantly higher than that in the controls (5.128%±0.592%, P<0.05). The level of HbA1c in patients with cerebral infarction and the neurological deficits scores were positively correlated (r=0.760, P<0.05). The level of HbA1c in patients with 2 lesions (6.635%±0.427%) was obviously higher than that in patients with 1 lesion (5.803%±0.307%, P<0.05); The level of HbA1c in patients with 3 or more lesions (8.571%±0.519%) was obviously higher than that in patients with 1 or 2 lesions (P<0.05). Conclusion Diabetes is a major risk factor for cerebral infarction. High HbA1c level might cause a series of cerebrovascular diseases, thus it is an important factor in the happening of cerebral infarction and HbA1c level is an important indicator of the early assessment of the severity of the diseases. The incidence of cerebral infarction can be decreased by controlling hyperglycaemia, lowering the HbA1c levels.