糖尿病并发急性脑梗死患者血清Hcy水平变化及其相关性研究

目的 分析2型糖尿病(T2DM)并发急性脑梗死(AIS)患者血清Hcy水平变化及其相关性研究.方法 选取2019年6月至2021年6月恩施土家族苗族自治州中心医院收治的T2DM患者427例,根据患者是否合并AIS分为对照组(T2DM,n=129)和实验组(T2DM合并AIS,n=298),对T2DM合并AIS患者根据N...

Changes and correlation of serum Hcy levels in diabetic patients complicated with acute cerebral infarction

Objective To analyze the changes and correlation of serum Hcy level in patients with type 2 diabetes mellitus(T2DM)complicated with acute cerebral infarction(AIS).Methods A total of 427 T2DM patients admitted to our hospital from June 2019 to June 2021 were selected and divided into the control group(T2DM,n=129)and experimental group(T2DM combined with AIS,n=298)according to whether the patients were complicated with AIS.According to NIHSS score,the patients in the experimental group subsequently were divided into the mild group(NIHSS score<7 points,n=51),moderate group(7≤NIHSS score 7-15 points,n=43)and severe group(NIHSS score>15 points,n=35).According to infarct size,the patients in the experimental group were divided into the lacunar cerebral infarction group(n=57),small area cerebral infarction group(n=45)and large area cerebral infarction group(n=27).The basic data of all patients,including age,gender,history of hypertension,stroke and smoking,were collected by self-made scale.The levels of FBG,TG,LDL-C,SBP and serum Hcy were compared between the groups.Logistic regression analysis was used to screen the independent risk factors for development of AIS in T2DM patients.Spearman was applied to analyze the correlation between serum Hcy level and the degree of neurological impairment as well as infarct area in T2DM patients with AIS.Results There were statistically significant differences in age,history of hypertension,stroke,smoking,and the levels of TG,LDL-C,FBG,SBP,Hcy between the control and experiment groups(P<0.05).Logistic regression analysis showed that age and the levels of TG,FBG,SBP,Hcy were independent risk factors for development of AIS in T2DM patients(P<0.05).The serum Hcy level in severe group was significantly higher than that in mild and moderate groups,and it in moderate group was significantly higher than that in mild group(t=16.995,t=8.850,t=12.163,P<0.05).The serum Hcy level in large area cerebral infarction group was significantly higher than that in lacunar and small area cerebral infarction groups,and it in small cerebral infarction group was significantly higher than that in lacunar cerebral infarction group(t=8.677,t=2.858,t=7.028,P<0.05).Spearman correlation analysis showed that serum Hcy level was positively correlated with the degree of neurological impairment and infarct area in T2DM patients with AIS(r₁=0.459,r₂=0.513,P<0.05).Conclusions T2DM patients with old age,poor control of smoking,blood glucose,blood pressure and blood lipids are at greater risk of AIS development.The serum Hcy level of T2DM patients with AIS is significantly increased,which can be monitored to determine the degree of neurological impairment and infarct area of T2DM patients with AIS.