摘要
目的探讨血糖、血脂等因素对2型糖尿病（DM）患者脑白质疏松（LA）严重程度的影响。方法选取参加2010年我国华南地区脑卒中并发偏瘫的综合防治的多中心研究的106例2型DM并皮质下血管性痴呆（SVD）患者，静脉抽血检测糖化血红蛋白（HbAlc）、空腹血糖（FPG）、餐后2h血糖（2HPG）、甘油三脂（TG）、总胆固醇（CHOL）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）；行头颅MRI检查，对皮质下白质高信号影（DWMH）和脑室周围白质高信号影（PVH）严重程度进行分级（1级、2级、3级1。并应用半定量方法计算LA分数。多重线性回归分析LA分数的影响因素；比较不同HbAlc水平患者的临床特征；分析DWMH程度和PVH程度与其他因素的相关性并比较不同DWMH和PVH程度组患者的临床特征。结果患者LA分数与HbAIc、年龄呈正相关关系（r=0．457，P=-0．000；r=0．400，P=0．000），多重线性回归分析LA分数会随HbAlc、年龄的增加而增加（P〈0．05）；不同HbAlc水平患者LA分数不同，差异有统计学意义（P〈0．05）；DWMH程度和PVH程度分别与HbAlc、年龄呈正相关关系（r=0．385，P=0．000，r=0．361，P=-0．000；r=0．458，P=-0．000，r=0．364，P=0．000），不同DWMH和PVH程度组间比较脑卒中史患者比例不同，差异有统计学意义（P〈0．051，校正年龄的影响后，DWMH程度和PVH程度均与HbAlc水平呈正相关关系（r=0．253，P=0．009；r=0．318，P=0．001）。结论血清HbAlc水平是反映2型DM患者大量LAf包括DWMH、PVH）的重要生化指标。年龄、卒中史与2型DM患者LA严重程度有关。未发现血脂水平与2型DM患者大量LA严重程度相关。
Objective To investigate the relationships between the risk factors （the levels of blood glucose and blood fat） and the severity of leukoaraiosis （LA） in patients with type 2 diabetes. Methods The risk factors （including levels of plasma HbAlc, fasting blood glucose, 2 hours blood glucose after meals, triglyceride, total cholesterol, high density lipoprotein, and low density lipoprotein） were measured and the head magnetic resonance were used in the selected patients who were diagnosed as having subcortical vascular dementia and type 2 diabetes （n=106）. According to the Fazekas＇s classification of signals of deep white matter hyperintense （DWMH） and periventricular hyperintense （PVH）, the severity of LA was graded as grade 1, 2 and 3 by its appearance under MRI. LA scores were obtained by its appearance under MRI according to the semiquantitative way; the influencing factors of LA scores were analyzed using multiple linear regression. The clinical features of patients with different plasma HbAlc levels were compared; the relations of signals of DWMH and PVH with other risk factors were compared; and the clinical features of patients with different signals of DWMH and PVH were compared too. Results LA scores were positively related to HbAlc level and age （r=0.457, P=0.000;r=0.400, P=0.000）. The signals of DWMH and PVH were positively related to the HbAlc level and age （r=0.385, P=0.000; r=0.361, P=0.000; r=0.458, P=0.000; r=0.364, P=0.000）. Statistical significance of stroke history in different signals of DWMH and PVH was noted （P〈0.05）. After adjusting the age, signals of DWMH and PVH were positively correlated to the HbAlc level （r=0.253, P=0.009; r=0.318, P=0.001）. Conclusion In the patients with type 2 diabetes, the plasma level of HbAlc is an important biochemical indicator which reflects the severity of LA （including DWMH and PVH）; age and stroke history are relative with the severity of LA, while blood fat level is not correlated to the severity of LA.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2013年第1期62-67,共6页
Chinese Journal of Neuromedicine
基金
广州市科技计划重大专项（2011Y200017）
