非糖尿病性急性脑梗死患者血液糖化血红蛋白检测

目的:探讨血液糖化血红蛋白(GHbAlc)含量与颈动脉粥样硬化及脑梗死的关系。方法:选择病程在1周内的非糖尿病性脑梗死急性期患者68例作为脑梗死组,50例健康体检者作为对照组,采用高效液相离子交换层析法测定血液GHbAlc含量,应用彩色多普勒测量颈动脉内中膜厚度(IMT),计算颈动脉狭窄程度,观察颈动脉斑块的性质,分析GHbAlc含量与颈动脉狭窄程度的相关性;对全部脑梗死患者于入院当天进行神经功能缺损程度评分,分析脑梗死患者GHbAlc含量与其神经功能缺损程度评分的关系。结果:脑梗死组患者血液中GHbAlc含量(6.728%±1.612%)明显高于对照组(5.243%±0.629%)(t=6.172,P<0.001);2组患者血液中GHbAlc含量均与颈动脉狭窄程度成正相关(r=0.560,0.483;P<0.05)。脑梗死组软斑、混合斑和硬斑数目分别为86、49和27,对照组分别为15、8和28,2组斑块构成差异有统计学意义(χ2=29.619,P<0.001),脑梗死组软斑和混合斑比例明显高于对照组。随着脑梗死患者神经功能缺损程度评分的增加,GHbAlc含量亦明显增加(F=329.431,P<0.001)。结论:GHbAlc促进了动脉粥样硬化的发生、发展,可能是非糖尿病性脑梗死的危险因素之一。

Determination of blood glycated hemoglobin Alc in acute cerebral infarction patients without diabetes

Aim:To investigate the relationship between the blood glycated hemoglobin Alc(GHbAlc) level with carotid atherosclerosis and cerebral infarction.Methods:A total of 68 patients with acute cerebral infarction within 1 week after first onset were chosen as observation group,and 50 age and sex matched healthy controls were selected as control.The level of blood GHbAlc was quantified with high effect liquid phase ion exchange chromatography.Measuring the carotid intimamedia thickness(IMT),calculating the degree of carotid stenosis,observing the character of atherosclerotic plaques,and observing the relation between GHbAlc level and the degree of carotid stenosis.The patients in observation group were performed neurological deficits scales after the admission.The relation between GHbAlc level and neurological deficits scores was explored.Results:The GHbAlc level in the observation group(6.728% ± 1.612%) was significantly higher than that in the controls(5.243% ± 0.629%)(t = 6.172,P < 0.001).The GHbAlc level showed a positive correlation with the degree of carotid stenosis in both groups(r = 0.560,0.483;P < 0.05).The numbers of soft plaque,mixed plaque and hard plaque in the observation group were 86,49 and 27;compared with those(15,8 and 28) in the control group,the difference was significant(χ2 = 29.619,P < 0.001).The proportion of soft plaque and mixed plaque in the observation group was significantly higher than that in the control group.With the increase of neurological deficit scores,the GHbAlc level in the observation group was also significantly increased(F = 329.431,P < 0.001).Conclusion:GHbAlc can promote the development of the carotid atherosclerosis.GHbAlc can be one of risk factors for non-diabetic cerebral infarction.