摘要
目的 通过对脑白质疏松（LA）危险因素的相关分析,探讨其中糖代谢与LA相关性.方法 选取2013年6月-2014年5月因各种原因入住舟山医院神经内科的患者,年龄50～ 80岁.测得糖化血红蛋白（HbAlc）水平,按其是否高于标准值,随机抽取升高及正常患者各100例.同时检测入组者空腹血糖（FPG）、低密度脂蛋白（LDL-C）、叶酸、维生素B12及同型半胱氨酸（HCY）.并对人组者进行头颅MR检查,通过MRIcro软件定量计算LA体积分数.采用Spearman检验分析各个因素与LA的相关性.再对其进行偏相关分析,进一步排除混杂因素影响,明确糖代谢异常的相关指标与LA严重程度间的关联.结果 患者LA体积分数与年龄（r=0.28,P=0.00）、高血压病史（r=0.25,P=0.00）、糖尿病史（r=0.36,P=0.00）、卒中史（r=0.20,P=0.01）、空腹血糖（r=0.39,P=0.00）及HbAl c（r =0.68,P=0.00）呈正相关.在调整年龄、高血压及卒中史后,糖代谢异常仍与LA相关,其中HbAlc与LA的相关性最高（r=0.47,P=0.00）.结论 年龄、高血压病史、卒中史、糖代谢异常与LA的严重程度相关,其中HbAlc与LA严重程度呈正相关.因此,糖代谢指标中HbAlc是LA一个重要的危险因素,且可能从脑缺血/低灌注（血管解剖因素）及血脑屏障因素两方面对LA的发生产生影响.
Objective To analyze the risk factors for leukoaraiosis （LA）, and explore the relationship between LA and abnormal glycometabolism. Methods We observed 200 patients with different diseases who admitted to the department of neurology in Zhoushan hospital from June 2013 to May 2014, age ranged from 50 -80 years old. According to the level of the patients＇ glycosylated hemoglobin（ HbAlc）, they were divided into normal level group and high level group, each group included 100 patients. The risk factors data including fasting blood-glucose, low density lipoprotein cholesterol （LDL-C） ,folic acid, vitamin B12 and homocysteine were collected. All the patients received cranial MRI examinations. The volume of LA was counted by the MRIcro software. And the correlation between LA and all of those risk factors were calculated by the Spearman test. To exclude the influence of confounding factors, a partial correlation analysis was used in a further analysis between abnormal glycometabolism and LA. Results The correlation between LA and age （ r = 0.28, P = 0.00）, hypertension （ r = 0.25, P = 0.00）, diabetes history （ r = 0.36, P = 0.00 ）, stroke individuals （ r = 0.20, P = 0.01 ）, fasting glucose （ r = 0.39, P = 0.00）, and glycosylated hemoglobin （ r = 0.68,P = 0.00 ）. After adjusting the influ- ence of age , hypertension and stroke individuals, LA was still correlated with abnormal glycometabolism, and HbA1 c had the highest correlation （ r = 0.47, P = 0.00）. Conclusions Age, hypertension, diabetes, stroke individuals and abnormal glycometabolism are all correlated with LA. Among them, HbAlc levels and the severity of LA were positively correlated. In the related index of the abnormal glycometabolism,HbAlc is an important risk factor of LA. HbAlc probably may take effect through vascular anatomical factors and blood-brain barrier factors in the occurrence of LA.
出处
《中华全科医学》
2015年第10期1579-1581,共3页
Chinese Journal of General Practice
基金
浙江省医药卫生平台计划重点资助项目(2014ZDA026)
关键词
脑白质疏松
糖代谢异常
糖化血红蛋白
Leukoaraiosis
Abnormal glycometabolism
Glycosylated hemoglobin
