老年颈动脉粥样硬化患者糖化血红蛋白和空腹血糖水平与病变严重程度的相关性研究
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摘要
目的 :探讨老年颈动脉粥样硬化患者的糖化血红蛋白及空腹血糖水平与其病变严重程度间的相关性。方法:选择2017年5月1日至2018年5月31日在上海交通大学医学院附属瑞金医院卢湾分院老年科住院的144例颈动脉粥样硬化患者,按照血管超声检查结果将其分为颈动脉轻中度粥样硬化组和颈动脉严重粥样硬化组,记录一般情况、相关病史,并计算颈动脉斑块Crouse积分;留取患者入院第二日清晨的空腹血标本,检测糖化血红蛋白、空腹血糖水平并进一步分析,探讨颈动脉粥样硬化病变严重程度与糖化血红蛋白、空腹血糖间的相关性。结果:与颈动脉轻中度粥样硬化组相比,颈动脉严重粥样硬化组的空腹血糖[(6.86±1.98) mmol/L比(5.72±1.33) mmol/L,P<0.05]、糖化血红蛋白[(6.47±2.53)%比(5.43±1.24)%,P<0.05]均明显升高。logistic回归分析显示,糖化血红蛋白(r=0.578,P<0.05)、空腹血糖(r=0.479,P<0.05)与颈动脉粥样硬化的严重程度呈正相关。结论:老年颈动脉粥样硬化患者的糖化血红蛋白及空腹血糖水平与其颈动脉粥样硬化严重程度显著相关。
Objective: To investigate the correlation of glycosylated hemoglobin and fasting blood glucose level with severity of lesion in elderly patients with carotid artery atherosclerosis. Methods: A total of 144 patients with carotid artery atherosclerosis admitted to the Geriatrics Department of Shanghai Ruijin Hospital Luwan Branch from May 1, 2017 to May 31, 2018 were enrolled. According to the results of vascular ultrasonography, patients were categorized into moderate atherosclerosis group and severe atherosclerosis group. The general condition and related medical history were recorded, and the Crouse score of carotid artery plaque was calculated. On the second day of admission, fasting blood sample was taken to detect glycosylated hemoglobin and fasting blood glucose level. The correlation of glycosylated hemoglobin and fasting blood glucoselevel with severity of atherosclerotic lesion was analyzed. Results: Compared with moderate atherosclerosis group, the fasting blood glucose level [(6.86±1.98) mmol/L vs(5.72±1.33) mmol/L, P<0.05] and glycated hemoglobin [(6.47±2.53)% vs(5.43±1.24)%, P<0.05) of severe atherosclerosis group were significantly increased. Logistic regression analysis showed that glycated hemoglobin(r=0.578, P<0.05) and fasting blood glucose level(r=0.479, P<0.05)were positively correlated with the severity of carotid artery atherosclerosis. Conclusions: Glycated hemoglobin and fasting blood glucose level in elderly patients with carotid artery atherosclerosis are correlated significantly with the severity of carotid artery atherosclerosis.
Objective: To investigate the correlation of glycosylated hemoglobin and fasting blood glucose level with severity of lesion in elderly patients with carotid artery atherosclerosis. Methods: A total of 144 patients with carotid artery atherosclerosis admitted to the Geriatrics Department of Shanghai Ruijin Hospital Luwan Branch from May 1, 2017 to May 31, 2018 were enrolled. According to the results of vascular ultrasonography, patients were categorized into moderate atherosclerosis group and severe atherosclerosis group. The general condition and related medical history were recorded, and the Crouse score of carotid artery plaque was calculated. On the second day of admission, fasting blood sample was taken to detect glycosylated hemoglobin and fasting blood glucose level. The correlation of glycosylated hemoglobin and fasting blood glucoselevel with severity of atherosclerotic lesion was analyzed. Results: Compared with moderate atherosclerosis group, the fasting blood glucose level [(6.86±1.98) mmol/L vs(5.72±1.33) mmol/L, P<0.05] and glycated hemoglobin [(6.47±2.53)% vs(5.43±1.24)%, P<0.05) of severe atherosclerosis group were significantly increased. Logistic regression analysis showed that glycated hemoglobin(r=0.578, P<0.05) and fasting blood glucose level(r=0.479, P<0.05)were positively correlated with the severity of carotid artery atherosclerosis. Conclusions: Glycated hemoglobin and fasting blood glucose level in elderly patients with carotid artery atherosclerosis are correlated significantly with the severity of carotid artery atherosclerosis.
引文
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[11]李雯,周勇,刘雪梅,等.中老年人群颈动脉斑块的检出率及其影响因素[J].中华高血压杂志,2012,20(3):232-236.
[12] Brinkmann C, Schwinger RH, Brixius K. Physical activity and endothelial dysfunction in type 2 diabetic patients:the role of nitric oxide and oxidative stress[J]. Wien Med Wochenschr,2011,161(11-12):305-314.
[13] CéGV, Rohde LE, da Silva AM, et al. Endothelial dysfunction is related to poor glycemic control in adolescents with type 1 diabetes under 5 years of disease:evidence of metabolic memory[J]. J Clin Endocrinol Metab,2011,96(5):1493-1499.
[14] Sztanek F, MolnárnéMolnárá, Balogh Z. The role of oxidative stress in the development of diabetic neuropathy[J]. Orv Hetil,2016,157(49):1939-1946.
[15]范泉,郭文怡,贾国良.冠心病患者糖化血红蛋白水平与冠状动脉病变的相关性[J].第四军医大学学报,2006,27(8):698-700.
[16]布威麦尔耶姆·穆太力普,雷建新.糖化血红蛋白与冠心病关系的研究进展[J].世界最新医学信息文摘,2018,18(17):41-42.
[17]徐群,刘正湘.糖基化终末产物在心血管病变中的作用机制[J].实用心脑肺血管病杂志,2006,14(8):674-676.
[18]王迪文,钟兴,杜益君,等.医生糖尿病管理质量的改善对2型糖尿病群体血糖管理水平的影响[J].安徽医学,2019,40(2):164-168.
[19]周莹霞,张翼飞,王姝洁,等.强化胰岛素治疗的2型糖尿病患者夜间低血糖危险因素调查研究[J].内科理论与实践,2018,13(6):375-378.
[2] Kurihara O, Takano M, Yamamoto M, et al. Impact of prediabetic status on coronary atherosclerosis:a multivessel angioscopic study[J]. Diabetes Care,2013,36(3):729-733.
[3]张军亚.颈动脉粥样硬化与进展性缺血性脑卒中的关系[J].中国实用神经疾病杂志,2016,43(3):126-127.
[4]刘玉杰,张园园,王静慧.颈动脉硬化斑块与冠心病的关系[J].世界最新医学信息文摘,2016,16(37):86-86.
[5]张亚萍,杨历新,连新龙,等.老年高血压患者糖化血红蛋白水平与颈动脉粥样硬化的相关性[J].中国老年学杂志,2015,35(6):1672-1673.
[6] Ray A, Tamsma JT, Hovens MM, et al. Accuracy of carotid plaque detection and intima-media thickness measurement with ultrasonography in routine clinical practice[J]. Eur J Intern Med,2010,21(1):35-39.
[7] Zureik M, Bureau JM, Temmar M, et al. Echogenic carotid plaques are associated with aortic arterial stiffness in subjects with subclinical carotid atherosclerosis[J].Hypertension,2003,41(3):519-527.
[8] Crouse JR 3rd, Grobbee DE, O'Leary DH, et al. Carotid intima-media thickness in low-risk individuals with asymptomatic atherosclerosis:baseline data from the METEOR study[J]. Curr Med Res Opin,2007,23(3):641-648.
[9]原杰,张红霞,王丽佳,等.代谢综合征合并冠状动脉粥样硬化性心脏病患者心包周围脂肪体积与冠状动脉病变严重程度的相关性[J].中华健康管理学杂志,2014,8(3):155-159.
[10] Christoph Saely, Alexander Vonbank, Philipp Rein,Daniela Zanolin, Heinz Drexel. HbA1c is a significantly stronger predictor of cardiovascular event risk in women than in men among patients undergoing coronary angiography[J]. Journal of the American College of Cardiology,2014,63(12).【
[11]李雯,周勇,刘雪梅,等.中老年人群颈动脉斑块的检出率及其影响因素[J].中华高血压杂志,2012,20(3):232-236.
[12] Brinkmann C, Schwinger RH, Brixius K. Physical activity and endothelial dysfunction in type 2 diabetic patients:the role of nitric oxide and oxidative stress[J]. Wien Med Wochenschr,2011,161(11-12):305-314.
[13] CéGV, Rohde LE, da Silva AM, et al. Endothelial dysfunction is related to poor glycemic control in adolescents with type 1 diabetes under 5 years of disease:evidence of metabolic memory[J]. J Clin Endocrinol Metab,2011,96(5):1493-1499.
[14] Sztanek F, MolnárnéMolnárá, Balogh Z. The role of oxidative stress in the development of diabetic neuropathy[J]. Orv Hetil,2016,157(49):1939-1946.
[15]范泉,郭文怡,贾国良.冠心病患者糖化血红蛋白水平与冠状动脉病变的相关性[J].第四军医大学学报,2006,27(8):698-700.
[16]布威麦尔耶姆·穆太力普,雷建新.糖化血红蛋白与冠心病关系的研究进展[J].世界最新医学信息文摘,2018,18(17):41-42.
[17]徐群,刘正湘.糖基化终末产物在心血管病变中的作用机制[J].实用心脑肺血管病杂志,2006,14(8):674-676.
[18]王迪文,钟兴,杜益君,等.医生糖尿病管理质量的改善对2型糖尿病群体血糖管理水平的影响[J].安徽医学,2019,40(2):164-168.
[19]周莹霞,张翼飞,王姝洁,等.强化胰岛素治疗的2型糖尿病患者夜间低血糖危险因素调查研究[J].内科理论与实践,2018,13(6):375-378.