2型糖尿病对急性脑梗死患者软脑膜侧支循环的影响

目的:探讨2型糖尿病对急性脑梗死患者软脑膜侧支循环的影响。方法:选取2020年3月1日至2021年6月30日东莞市厚街医院收治的2型糖尿病合并急性缺血性脑梗死（大脑前动脉、大脑中动脉及颈内动脉颅内段闭塞或狭窄程度大于85%）患者作为研究对象（糖尿病脑梗死组），共94例，其中男51例，女43例，年龄（65.02±14.1...

Effect of type 2 diabetes mellitus on leptomeningeal collateral circulation in patients with acute cerebral infarction

Objective　To investigate the effect of type 2 diabetes mellitus on leptomeningealcollateral circulation in patients with acute cerebral infarction. Methods　Ninety-four type 2 diabetes patients with acuteischemic cerebral infarction and occlusion or over 85% stenosis of anteriorcerebral artery, middle cerebral artery, and internal carotid artery treated atHoujie Hospital from March 1, 2020 to June 30, 2021 were selected as a diabetesand cerebral infarction group, including 51 males and 43 females, and they were(65.02±14.15) years old. Ninety-four patients with acute ischemic cerebralinfarction of similar occlusion or stenosis and of similar age were selected asa control group, including 48 males and 46 females, and they were (68.20±12.63)years old. Regional leptomeningeal collateral (rLMC) score was used as anindicator to evaluate the leptomeningeal collateral circulation. The scores ofNational Institute of Health Stroke Scale (NIHSS) and Alberta Stroke Program EarlyCT Score (ASPECTS) of the two groups were evaluated. The related factors, suchas the age of onset, blood pressure, blood glucose, cholesterol, low-densitylipoprotein cholesterol (LDL-C), smoking history, drinking history, andhistories of cerebral infarction and coronary heart disease, were compared andanalyzed. The correlation regression analysis was carried out. Results　The rLMC score, NIHSS score at admission, andASPECTS score were (11.55±5.22), (11.99±8.57), and (5.26±2.45) in the diabetesand cerebral infarction group, and were (14.02±4.88), (10.03±8.75), and(6.27±2.53) in the control group, with statistical differences (P=0.001, 0.123, and 0.006). There werestatistical differences in blood glucose, smoking history, and drinking historybut not in the other indicators at admission between the two groups. Spearmancorrelation analysis of rLMC score showed that rLMC was significantlycorrelated with NIHSS score (r=-5.790, P<0.001) and ASPECTS score (r=0.556, P<0.001). Systolic pressure (r=0.207, P=0.045) anddiastolic pressure (r=0.213, P=0.040), cholesterol (r=0.244, P=0.018), and LDL-C (r=0.215, P=0.037) were all statisticallysignificant. Age (r=-0.089, P=0.392) and blood glucose (r=-0.292, P=0.120) were not statistically significant. Multiple regressionshowed that only ASPECTS and NIHSS scores were statistically associated withrLMC. Conclusions　Type  2 diabetes not only significantly affects the establishment ofleptomeningeal collateral circulation in patients with acute ischemic cerebralinfarction, but also affects the volume of cerebral infarction and the diseaseseverity. In addition to the effects of type 2  diabetes on leptomeningealcollaterals, it is possible that arterial blood pressure (systolic anddiastolic pressures), cholesterol, and LDL-C are associated with perfusion ofleptomeningeal collateral circulation.