脑梗死患者糖耐量减低与颈动脉粥样硬化的相关性研究

目的探讨脑梗死患者糖耐量减低（IGT）与颈动脉粥样硬化的关系。方法将120例急性脑梗死患者根据病史和口服葡萄糖耐量试验（OGTT）结果分为糖尿病（DM）组、IGT组、糖耐量正常组（NGT组）。对3组患者进行颈动脉超声检查,测定各组生化指标。结果与NGT组相比,IGT组和DM组的体重指数（BMI）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FPG）、餐后2h血糖（2hPG）、颈动脉内中膜厚度（CIMT）、斑块检出率及斑块积分均显著增高（P〈0.05）;Spearman相关性分析显示,CIMT与年龄、TC、LDL-C、2hPG呈正相关（P〈0.05或P〈0.01）。结论脑梗死患者在IGT阶段已经发生颈动脉粥样硬化改变,早期控制血糖,可减轻脑血管病变的严重程度、减少血管事件发生。

The Observation of Relationship between Impaired Glucose Tolerance and Carotid Atherosclerosis in Cerebral Infarction

Objective To observe the relationship between impaired glucose tolerance（IGT） and carotid atherosclerosis in patients（pts） with acute cerebral infarction.Methods One hundred and twenty pts with acute cerebral infarction were divide into diabetes mellitus（DM） group,IGT group,and normal glucose tolerance（NGT） group based on history and the oral glucose tolerance test（OGTT）.Carotid color Doppler ultrasound examinations were performed.Some biochemical indices were measured simultaneously.Results Compared with NGT group,the body mass index（BMI）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）,fasting plasma glucose（FPG）,2 h postprandial blood glucose（2 h PG）,carotid intima-media thickness（CIMT）,the incidence rates of carotid atherosclerosis and plaque score were significantly increased in DM group and IGT group（P0.05）.Spearman rank correlation analysis showed：Age,TC,LDL-C,and 2-h PG were positively correlated with CIMT（P0.05 or P0.01）.Conclusion In the stage of IGT,pts with acute cerebral infarction had manifestations of carotid atherosclerosis.The result suggested that controlling hyperglycemia early might effectively reduce the severity of cerebrovascular lesion and the incidence of vascular events.